Spine Injections for Pain Management

Interventional radiologists use X-ray imaging to help guide an injection of medication to specific areas of pain. Such procedures are often used to delay back or neck surgery. Injections can be used to alleviate pain in the neck, shoulder, arm, back, buttock, hip and/or leg.

Spine injections serve two purposes. First, by placing pain medicine into the joint, the amount of immediate pain relief helps physicians identify the source of pain. After that, steroids may be injected into the joints to reduce inflammation that can, in many cases, provide long-term pain relief.

Physicians numb the skin and then use X-ray guidance to direct a very small needle into the joint. Contrast dye is injected into the area to provide physicians with a better view and allow precise placement of the needle and medication.

A mixture of pain medication and an anti-inflammatory is then slowly injected in the joint. Patients may feel as if their spine is slightly weak, numb or odd for a few hours after the injection. Some patients notice a slight increase in pain that lasts for several days, as the pain medication wears off before the anti-inflammatory medicine takes effect.

Patients can usually leave the hospital the same day they have the procedure and can return to regular activities after 24 hours.

Facet Blocks and Nerve Blocks

• Cervical, Thoracic and Lumbar Facet Blocks: Facet blocks target the facet joints, located at each segment of the spine, that provide stability and help guide motion. Facet joints can become painful due to arthritis of the spine, injury or stress to the back. A cervical (head, neck, shoulder, arm), thoracic (upper back) or lumbar (lower back, leg pain) facet joint injection involves injecting medication to anesthetize the facet joints and block the pain.
• Cervical, Thoracic and Lumbar Nerve Blocks: Nerve blocks target the nerves with medication that can turn off nerve-related pain. Medications injected include local anesthetics, steroids and opioids. In cases of severe pain, physicians may destroy the nerve by using needles that freeze or heat the nerves.