Spinal injections are used to deliver a combination of local anaesthetic and steroid into or near the spine to ease back pain and improve function, and sometimes to help identify the source of back pain by numbing certain areas. Injections into or near the spine help deliver pain-reducing medicines directly to the source of pain and are usually recommended for relief of back pain or sciatica (shooting pain down one or both of your legs). The effects of a successful spinal injection can last from a few weeks to several months.
Medications injected include:
- Bupivacaine or marcaine – a slower acting and longer lasting local anaesthetic.
- Cortisone – a strong long lasting anti-inflammatory. It can take several days to work, but its effect can last for months.
Injection techniques used include:
An epidural injection is delivered into the epidural space of the spine to provide temporary or prolonged relief from pain or inflammation. The epidural space is located outside the dural membrane. Anaesthetics and anti-inflammatory medications are typically delivered in an epidural injection. The injection may reduce pain and swelling in and around the spinal nerve roots, as well as around damaged nerves which in time may heal.
Spinal nerve root block (periradicular)
A nerve block is the induction of regional anaesthesia by preventing sensory nerve impulses from reaching the spine. It is accomplished by injecting a long acting local anesthetic solution around the nerve. Sometimes steroid is injected also to help relieve inflammation surrounding the nerve. Nerve blocks are most often used to produce anaesthesia in specific areas of the body.
Facet joints (also called zygapophyseal joints) are small joints of the spine that provide stability and help guide motion. They are found in the neck (cervical), upper back (thoracic) and lower back (lumbar). They can become painful as a result of arthritis, injury or mechanical stress. However, this is not necessarily the sole cause of long term back pain.
Two nerves called “medial branches” supply each facet joint. These nerves carry pain signals to the spinal cord and these signals will eventually reach the brain.
The facet joints and/or medial branch nerves can be injected with a local anaesthetic and/or steroid.
Sacroiliac (SI) joint injections are diagnostic injections that provide an attractive, objective means of diagnosing joint pain.