Injections

Injections & Pain Management

Medial Branch Nerve Blocks Risks, Complications, and Follow-Up Results

Ben Parr — Tue, 02 Sep 2008 12:22:18 -0700

Medial branch nerve block results and follow-up

The medial branch nerve block is designed to interrupt the pain signal being carried by the medial branch nerves that supply a specific facet joint. Because of this, patients may feel complete or partial pain relief during the first 6 to 12 hours after an injection. They may also feel no pain relief during this time (anesthetic phase).

Facet Joint Injection Results and Follow-up

Ben Parr — Mon, 14 Jul 2008 14:32:38 -0700

On the day a patient is to receive a facet joint injection, they are advised to avoid doing any strenuous activities, unless instructed by their physician. The patient should not drive the day of the injection unless approved by the treating physician. If sedation was used, the patient should not drive for 24 hours after the procedure.

Injections for Back Pain Management

spine-health — Wed, 12 Dec 2007 00:10:00 -0800

Selective nerve root block (SNRB) for diagnosis and back pain management

Another common injection, a selective nerve root block (SNRB), is primarily used to diagnose the specific source of nerve root pain and, secondarily, for therapeutic relief of low back pain and/or leg pain (see Figure 1).

Facet Rhizotomy and Sacroiliac Joint Block Injections

spine-health — Wed, 12 Dec 2007 00:10:00 -0800

Facet rhizotomy injection

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Injections for Pain Management

Epidural Steroid Injections

spine-health — Wed, 12 Dec 2007 00:10:00 -0800

How an epidural steroid injection works

The most commonly performed injection is an epidural steroid injection. In this approach, a steroid is injected directly around the dura, the sac around the nerve roots that contains cerebrospinal fluid (the fluid that the nerve roots are bathed in). Prior to the injection, the skin is anesthetized by using a small needle to numb the area in the low back (a local anesthetic).

Injections for Back Pain Relief

spine-health — Wed, 12 Dec 2007 00:10:00 -0800

Injections comprise another relatively conservative treatment option for low back pain. They are typically considered as an option to treat low back pain after a course of medications and/or physical therapy is completed, but before surgery is considered. Injections can be useful both for providing pain relief and as a diagnostic tool to help identify the source of the patient’s back pain.

Radiofrequency Neurotomy for Facet and Sacroiliac Joint Pain

spine-health — Wed, 12 Dec 2007 00:10:00 -0800

What is Prolotherapy Treatment for Chronic Back Pain?

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

How prolotherapy for chronic back pain works

In prolotherapy treatment, often used for chronic back pain, a substance is injected using a slender needle next to the site where soft tissue (ligament, tendon, muscle, fascia, joint capsule) is injured or has torn away from the bone.

The substance used in the prolotherapy injection is a natural irritant agent. Examples include:

Sugar (dextrose or glucose) alone or in combination with glycerin and phenol
Sodium morrhuate (a purified derivative of cod liver oil)
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Potential Risks of an Epidural Steroid Injection

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Epidural Steroid Injection Pain Relief Success Rates

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Patients will find that the benefits of an epidural steroid injection include a reduction in pain, primarily in leg pain (also called sciatica or radicular pain). Patients seem to have a better response when the epidural steroid injections are coupled with an organized therapeutic exercise program.

Costovertebral and Costotransverse Joint Injection Results and Follow-Up

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

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Some Studies Have Linked Prolotherapy to Low Back Pain Relief

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

More than 20 clinical studies have documented the effects of prolotherapy on low back pain. Like many other treatments used for low back pain, the results of these studies have been somewhat mixed.³ This is due to several factors including the type of study, the methods used, and the scientific rigor of the studies.

Potential Risks and Complications of Prolotherapy

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

The injection technique involved in prolotherapy requires skill and care on the part of the physician. Training and experience are important.

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How Frequently Can Epidural Steroid Injections Be Performed?

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

There is no definitive research to dictate the frequency of how often a patient should have epidural steroid injections for low back pain and/or leg pain. In general, it is considered reasonable to perform up to three epidural injections per year.

Epidural Results and Precautions

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

As with any medical procedure, there are certain drawbacks and potential risks associated with an epidural steroid injection for back pain, leg pain or arm pain. One of the most important issues to consider is that the procedure only tends to significantly lessen the patient’s pain about half of the time.

What Are Current Indications for Prolotherapy?

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

There are currently no treatment guidelines or protocol for prolotherapy. It is most commonly used for patients with back pain caused by chronic ligament and tendon sprains and strains. Some physicians do use prolotherapy as a first-line therapy.

It is important to note that approximately 90% of people with acute back pain get better with standard conservative treatments within 6 to 8 weeks and do not require additional treatment.

Candidates for prolotherapy might include patients with back pain who:

Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Costotransverse and Costovertebral Joint Injections

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Rib dysfunction syndromes may cause one or a combination of the following symptoms: upper back pain, arm pain, pain between the ribs, and/or generalized upper back area discomfort. Patients with upper back pain and the above symptoms may be candidates for a costotransverse or costovertebral joint injection to both help diagnose the condition and provide pain relief.

Prolotherapy for Low Back Pain

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Prolotherapy: an alternative low back pain treatment

Recent surveys have concluded that over half the adults with low back pain or neck pain in the U.S. use complementary or alternative medicine (CAM) to treat their pain.

Medial Branch Nerve Blocks

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Pain caused by the facet nerves

Medial branch nerves are small nerves that feed out from the facet joints in the spine, and therefore carry pain signals from those joints. Facet joint injections are often used to identify a pain source; however, these injections, and other treatments that may be tried, do not always provide lasting pain relief.

How Epidural Steroid Injections Work

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Understanding Epidural Injections

An epidural steroid injection delivers steroids directly into the epidural space in the spine. Sometimes additional fluid (local anesthetic and/or a normal saline solution) is used to help ‘flush out’ inflammatory mediators from around the area that may be a source of pain.

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Cervical, Thoracic and Lumbar Interlaminar Epidural Injections

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Epidural steroid injections

An epidural injection delivers steroids into the epidural space around spinal nerve roots to relieve pain - back pain, leg pain, or other pain—caused by irritated spinal nerves. The steroid used in the epidural steroid injection reduces the inflammation of those nerves, which is often the source of the pain.

Prolotherapy and Chronic Back Pain

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Prolotherapy introduction

Prolotherapy is a non-surgical injection procedure used to treat connective tissue injuries of the musculoskeletal system that have not healed by either rest or conservative therapy in order to relieve back pain. The injections promote a healing response in small tears and weakened tissue, with the goal of alleviating back pain and improving function. Prolotherapy is also referred to as sclerosant therapy, sclerotherapy, regenerative injection therapy, “proliferative” injection therapy and nonsurgical ligament reconstruction.

Indications for Lumbar Epidural Injections

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Several common conditions that cause severe acute or chronic low back pain and/or leg pain (sciatica) from nerve irritation can be treated by steroid injections. These conditions include:

A lumbar disc herniation, where the nucleus of the disc pushes through the outer ring (the annulus) and into the spinal canal where it pressures the spinal cord and nerves. Read Lumbar herniated disc for more information on diagnosis and treatments.
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Hip Joint Injections for Pain Relief

spine-health — Wed, 12 Dec 2007 00:09:59 -0800

Pain caused by the hip joint

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