Spinal injections comprise another relatively conservative treatment option for chronic back pain. They are used both to learn more about what is causing your pain and to treat your pain. Doctors refer to these two separate uses of spinal injections as diagnostic and therapeutic. In some instances, the spinal injection procedure is used in combination with other imaging tests, such as fluoroscopy or CT.
Diagnostically, injections can be used to help determine which structure in the back is generating pain. For example, if an injection provides pain relief in the area that is injected, it is likely that this particular area is the source of the problem. Once the location of one or more sources of pain is discovered, your physician can perform other necessary tests to try to determine the actual problem and create the appropriate treatment.
Therapeutic injections can occasionally be more effective for pain relief than an oral medication because they deliver medication directly to the anatomic location that is generating the pain. Typically, a steroid and/or anaesthetic medication are injected to deliver a powerful anti-inflammatory solution directly to the area that is the source of pain. Depending on the type of injection, some forms of low back pain relief may be long lasting and some may be only temporary.
For all procedures, fluoroscopy (x-ray images on a TV monitor) is used to guide placement of the needle that delivers contrast material and medication to the area of pain.
Common injections include:
- Selective nerve root block (SNRB)
- Facet joint block
- Sacroiliac joint block