Injections are a non-surgical procedure where a patient is injected with a combination of anesthetic and steroid directly into the spine. The anesthetic serves to ease pain, while the steroid helps with inflammation. Two kinds of injections used to relieve pain and inflammation are Facet Joint Injections and Spinal Epidural Injections. Injections can act as a diagnostic tool by helping the physician determine if the area injected is the area causing pain. Injections may cause temporary or permanent effects, depending on the patient and his or her case.
Who needs this procedure?
If a degenerative spinal condition in a patient's spine is causing compression of spinal nerves, it can create acute or chronic pain, numbness, and weakness. Conservative treatments like injections are tried first to relieve the patient's symptoms before spine surgery is considered.
Epidural Steroid Injections
Following are the general steps involved in Epidural Steroid Injections:
Larger Needle Inserted
Contrast Dye Injected
End of Procedures
The patient lies face down, and a cushion is placed under the stomach area to provide comfort and to flex the back. In this position, the spine opens and allows for easier access to the epidural space. A fluoroscope assists the physician in locating the appropriate lumbar vertebra and nerve root. A local anesthetic is used to numb the skin.
All the tissue down to the surface of the lamina portion of the lumbar vertebra bone is anesthetized.
The physician slides a thicker needle through the anesthetized track.
A contrast solution is injected. The physician uses the fluoroscope to see the painful areas and to confirm the correct location of the needle tip.
A steroid-anesthetics mix is injected into the epidural space, bathing the painful nerve root with soothing medication.
The needle is removed, and a small bandage is applied to cover the tiny needle surface wound. In some cases, it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. Many patients get significant relief from only one or two injections.
Facet Joint Injections
Following are the general steps involved in Facet Joint Injections:
End of Procedure
A small area of skin is numbed with a local anesthetic injection.
Guided by fluoroscopic X-ray, a needle is placed into the facet joint. The correct placement of the needle is confirmed by injecting contrast dye into the joint.
A combination of a numbing anesthetic and an anti-inflammatory steroid medication is delivered to the joint through a thin needle. Depending on the location of pain, one or more injections may be administered. If the pain subsides after the injection, this suggests that the facet joint (or joints) injected were the cause of pain.
Back or neck pain may disappear immediately after a successful block. However, once the numbing effect of the anesthetic wears off, pain may return. It usually takes 5 to 10 days for the steroid medication to reduce inflammation and alleviate pain. Effects may last several days or several months. Up to three injections may be given per year.
What happens after the injection?
Facet Joint Injections usually take only 10-15 minutes to complete, and Spinal Epidural Injections take 15 to 30 minutes. Following the procedure, the patient will be monitored for half an hour to an hour in the recovery room. The patient should have an adult drive them home following the procedure. The patient should also relax and avoid any strenuous activity for at least 24 hours following the injection in order to allow the anti-inflammatory medication to take effect.
Note to patients
This material is intended to give the patient an overview of surgical procedures and treatments and is not intended to replace the advice and guidance of a physician. Always consult with your doctor about the particular risks and benefits of your treatment.