Treat Back Pain with Spinal Injections

Most often, back pain is caused by inflammation within the nerve cavities and where the nerve roots are located, which may be caused by a herniated disc over the nerve inflammation of joints. When the nerve is inflamed, it causes back pain. Pain along the muscles that the nerves go to, such as back pain, buttock pain, leg pain along with numbness, these symptoms can be treated by injecting medications into the nerve to reduce inflammation and back pain.

What is spinal injections

Spinal injection is a non-surgical way to relieve symptoms of back or neck pain. Most are injections of a combination of corticosteroids and anesthetics. Injected into the spinal cavity or near the area of ​​pain. This is done by using a mobile X-ray machine called fluoroscopy to check the correct position of the needle and confirm the position by injecting contrast dye.

Spinal injection help reduce swelling, inflammation of the compressed nerves. Improves the flow of blood vessels to the nerves in the spinal column. Nerves collapse and swelling from inflammation, thereby improving the patient's back pain. The injection will also help reduce numbness and weakness caused by nerve inflammation.

Spinal Injections Types

The choice of injection technique depends primarily on the location of the pain and other associated structures. The most common causes of pain are nerve root pain, fascistic joint pain, muscle pain, or a combination of these symptoms.

Epidural Steroid Injection (injection of steroids into the ventricles above the spinal cord)

Injection of steroids into the nerves above the spinal cord is done to treat pain caused by herniated disks pressing on nerves or degenerative spines pressing on or irritating nerves. Treatment success is usually better with early treatment and success rates vary.

• Symptoms occur less than 3 times. Month: 90% successful
• Symptoms occur around 6. Month: 70% successful
• Symptom 1 occurs. Year: 50% successful

Results can be temporary and last from weeks to years. Usually, patients need 1-2 injections to see results within 3-10 days after injection. The best results are achieved when treatment is given in combination with medication and/or physical therapy, as well as a home exercise program.

Facet Joint Injection

Injections into the facet joints are numbing injections and can be mixed with anti-inflammatory steroids into the facet joints or small nerves around the facet joints to help diagnose and treat pain by reducing inflammation. It also helps to identify the area of the spine that is causing the pain, if the pain is less, this may indicate that the facet joint is the cause of the pain, but if the pain does not decrease, this may indicate that the cause of the pain is at a different level or is caused by inflammation of the nerve roots due to disk compression, etc.

Sacroiliac Joint Injection (injection into the pelvic joint)

Injection of the drug into the pelvic joint, is a similar procedure to the injection of a facet joint, i.e., a mixture of corticosteroids and anesthetics into the pelvic joint. This can help in the accurate diagnosis and treatment of pelvic joint pain and is accurate in the diagnosis of pelvic joint pain.

Trigger Point Injection

Trigger point is a chronic muscle pain called myofascial pain syndrome in which pain occurs as a result of spasms and contraction of some muscle fibers, and refuse to relax. Which needs injecting a mixture of corticosteroids and anesthetics into the trigger point to relieve the pain.

Diseases that Can be Treated by Spinal Injections

Can be used for both

• herniated disc - the results of treatment for herniated discs are usually better because herniated discs have a chance of spontaneous healing.
• stenosis
• spinal degeneration or spinal nerves
• hip pain syndrome radiating down the leg from other reasons.

Who is Suitable for Spinal Injections

This method is especially suitable for patients who do not wish to undergo spinal surgery or are at high risk from surgery, including:

• People with pain until they are unable to perform normal daily life.
• People with pain that interferes with sleep
• Patients who are unsuccessful from other treatments such as oral medications and regenerative medicine.
• Patients with indications for spinal cavity injection.

Spinal Injections Procedure

1. The doctor will insert a small needle by an x ray to inject the medication.
2. The patient will be monitored for 30 minutes.
3. For safety, there should be someone to take the patient home and rest for at least 24 hours after, for some patients, the steroid will work for a few days.
4. Typically, the effect of intrathecal injections lasts about 3-6 months.

Spinal injections are most effective when combined with physical therapy and/or a home exercise program to strengthen the back and neck muscles. For patients whose pain has been relieved, additional treatment or surgery may not be necessary.

Result of Spinal Injections

The injection provides up to 70% reduction in pain relief. It generally lasts for 3-6 months, and most symptoms improve within 1 week after injection. The response to intrathecal injection therapy depends on the severity of the compressed nerve from herniated disc, including patient behavior and patient behavior. If the patient continues to return to work, lift heavy objects and sit on the floor, do the laundry, plant trees, or lift things incorrectly. It will make the back pain will recur. Symptoms may improve only during the injection or medication only.

However, back pain have a chance to recur because it a deterioration process of the body. The injection can be repeated according to symptoms. If the disc herniation is large and there is a lot of compression on the nerve or having difficulty urinating or urinary incontinence, your doctor may also consider treatment with endoscopic surgery to remove the part that has pressed on the nerve.

Spinal Injections Complications and Side effects

Complications of Spinal Injections

May have effects on diabetics, this may cause an increase in blood glucose levels and temporarily affect blood glucose control for about 1-2 weeks after injections.

Side effects of Spinal Injections

• This is because it is a specific injection that matches the area where the patient has inflammation. Therefore, the side effects are much less than oral steroids.
• At the initial stage, less than 1% of patients may experience numbness and a feeling of heaviness in the legs.  However, such symptoms subside after 2-3 hours.
• Other side effects include dizziness, increased pain syndrome, peak out at some point, or infected wounds, which are rare.

FAQ Related to Spinal Injections

How painful is a lumbar epidural steroid injection?

Pain during the procedure is very rare because an anesthetic is injected on the skin area before starting the procedure. And for some patients who are afraid of needles, the doctor applies a topical anesthetic on the skin. You can also take mild sleeping pills to relax before the procedure.

How soon can I exercise after epidural steroid injection?

After injection, symptoms usually improve within 1 week. One can start moving again, exercise and daily life gets better. Patients should avoid lifting heavy objects. They should not participate in activities with strong vibrations or activities that involve forceful and swift movements. This is to ensure that the therapeutic effect is sustained.

Spinal Injections Conclusion

However, back pain has a chance to recur because it a deterioration process of the body. The spinal injection can be repeated according to symptoms. If the disc herniation is large and there is a lot of compression on the nerve or having difficulty urinating or urinary incontinence, your doctor may also consider treatment with endoscopic surgery to remove the part that has pressed on the nerve.

Why choose Nakornthon Hospital?

At Nakornthon Absolute Spine Care, we are proud to be a treatment center with many spine specialists for results in treatment with a full range of technology for more effective surgery. Nakornthon Absolute Spine Care’s specialists will discuss every procedure with the team of medical consultants; to come to the final conclusion in choosing the best treatment (Last opinion) for all patients.

Therefore, there is no need to worry about its worth and the changes in the body that may not relieve as anticipated. Because Nakornthon Absolute Spine Care would wish all patients who stepped in with back pain problems, resume with a smile and perfect physical fitness once again.

Dr.Teerachat Tanasansomboon
Neurological Surgery/Spine
Spine Center

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