Today, there are many non-surgical options for back pain. Spinal Injections have quickly become a rapid request from patients suffering from severe pain. However, it is important to know all of the details and implications surrounding the injection prior to getting one.
Dr. Joseph Kay of AOA stresses that Spinal injections should only be performed with fluoroscopic (X-Ray) guidance. This greatly increases the success of the injection, while simultaneously dramatically decreasing the potential for a more serious complication.
Spinal Injections are primarily utilized for therapeutic treatment, facilitating in the recovery process. The two most important factors in determining the success of a spine injection are location and medication. Correct location hinges on the patient effectively identifying the involved spinal nerve(s), correlation with diagnostic imaging such as MRI or CT Scan, and physician physical examination confirmation of a spinal source of the pain/injury.
Safe steroid mixtures for spinal use include Kenalog, Depo-Medrol, and Dexamethasone. Only preservative-free steroids and anesthetics (ie: lidocaine) are safe. Preservatives in the steroid or anesthetic have been strongly associated with Arachnoiditis, a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surrounds and protects the nerves of the spinal cord. It is characterized by severe stinging, burning pain, and neurological problems.
Steroids are utilized to decrease inflammation. The sole, 100%, purpose of the steroid is to reduce the inflammatory reaction. This is in an effort to break the injury induced pain-inflammation cycle.
Steroid injections should not be considered as the only treatment. Rather, they should be considered as part of a complete treatment plan. This plan should include therapy to aide in the healing process. The comprehensive plan should also likely include medication to control pain and to help stabilize the involved nerves.
Be wary of a treatment plan that only involves the injection(s). Solo injection treatment is temporary and will not solve the issues.
Diagnostic spinal injections include medial branch blocks. These not only identify a facet joint as a source of spine pain, the response to the block is also predictive of a successful outcome for radiofrequency ablation of these small nerves as a means to treat facet-mediated pain.