Spine Injections Explained | Dr. Kris Radcliff NJ

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Spine Injections Explained

Spine injections can calm pain and, just as important, help find where the pain is coming from. They are done as an outpatient, usually in about 30 minutes, with numbing medicine and live X-ray to guide a thin needle to exactly the right spot. Light sedation is available.

Epidural Steroid Injection

When a disc bulge or bone spur irritates a nerve, the nerve becomes inflamed and sends pain down the arm or leg. An epidural steroid injection places a strong anti-inflammatory medicine right around the irritated nerve. A transforaminal injection reaches the opening where a single nerve leaves the spine; an interlaminar injection reaches the space behind the spinal sac.

The numbing medicine may help for a few hours.
The steroid usually takes 2 to 7 days to start working.
Relief often lasts several weeks to several months, and sometimes the nerve settles down for good.
A second injection is reasonable if the first one helped and the pain returns. We usually limit them to a few a year.

Medial Branch Blocks and Radiofrequency Ablation

The facet joints are small joints at the back of the spine that can cause neck or low back pain, especially with bending backward, twisting or standing up after sitting. Tiny nerves called medial branches carry pain from these joints.

Medial branch block: a small amount of numbing medicine is placed on those tiny nerves. It is a test. If your usual pain drops by at least half for the next several hours, the facet joints are the source.
Pain diary: rate your pain before the block and every hour for 6 hours afterward, and do the activities that usually hurt. The diary is how we read the test.
Radiofrequency ablation: if the blocks are positive, a heated needle tip quiets the same nerves. Relief usually lasts 6 months to a year, and it can be repeated.

Sacroiliac Joint Injection

The sacroiliac (SI) joints connect the spine to the pelvis. SI joint pain is usually felt low in the back and buttock, often on one side. An injection into the joint can relieve the pain and confirm the joint as the source. When injections help but the relief does not last, SI joint fusion may be an option.

Before and After

Tell us if you take a blood thinner. Do not stop it on your own.
If you have diabetes, check your blood sugar more often for a few days after a steroid injection.
You need an adult to drive you home if you have sedation.
Soreness at the needle site for a day or two is common. Ice helps.
Most people return to work the next day.
Call us for fever, redness or drainage at the needle site, new weakness that lasts more than a few hours, loss of bladder or bowel control, or a bad headache when sitting up.

When Injections Are Not Enough

If injections do not help, or help only briefly, that tells us something too. Depending on the cause, the next step may be endoscopic or minimally invasive surgery, disc replacement, or another approach. A surgical consultation is not a commitment to surgery.

Questions?

Offices in Somers Point, Cherry Hill, and Brick, New Jersey, as part of Progressive Spine & Orthopaedics.
New patients: 609-800-3472
Existing patients: 609-800-3472

This page is general information, not medical advice. Your treatment should be based on an evaluation by your own physician.