Back Pain Information     Center




 Introduction to Injections
Injections of local anesthetic and steroid can be used to relieve back pain.

 Procedure

Epidural Injections
The epidural space is within the spinal canal and surrounds the spinal cord. Steroid injections into this space can help to decrease inflammation of nerves and other soft tissues in the problematic area. These injections are usually given in a set of three for a cumulative effect. They are used for problems such as: Herniated discs, Sciatica, Radiculopathy, Narrowing of the Spinal Canal (Spinal Stenosis), and occasionally for Discogenic Low Back Pain. They can be given in the neck (cervical spine), upper back (thoracic spine), lower back (lumbar spine), and from the level of the tailbone (caudal approach).

Facet Injections
Facet joints are the joints in the posterior portion of the spine. There is one set of two facet joints between each vertebra in the spine. These joints can commonly be affected by arthritis and can cause back pain. Injections of local anesthetic and steroid can be used to relieve this pain.

Selective Nerve Root Blocks/Transforaminal Epidural Injection
Nerve root blocks use medications such as local anesthetics or steroids to disable a specific nerve root that is causing pain. Nerve root injury can often be localized by electrodiagnostic testing, and can be caused by herniated discs, stenosis, facet cysts, whiplash, or hyperextension injuries.

Sympathetic Blocks
These blocks are used to disrupt an abnormal pain cycle that can be caused by an overactive sympathetic nervous system. This condition is commonly referred to as complex regional pain syndrome (CRPS). It is also known as reflex sympathetic dystrophy (RSD), causalgia, shoulder hand syndrome, or sympathetic pain syndrome.

Intrathecal Pain Pump (Morphine Pump)
Intrathecal drug delivery systems are indicated for chronic intractable pain, cancer pain, and for chronic spasticity. Intrathecal drug delivery has been shown to increase pain relief and comfort for people with severe pain. It may also cause fewer side effects than oral medications. These benefits may help people with chronic pain improve their quality of life and participate more fully in daily activities.

Delivery makes the difference with intrathecal drug delivery. This therapy uses a small pump that is surgically placed under the skin of the abdomen to deliver medication directly in to the intrathecal space (the area surrounding the spinal cord). The medication is delivered through a small, soft tube called a catheter that is also surgically placed.

The spinal cord is like a highway for pain signals on their way to the brain, where your body experiences the feeling of pain. Because the drug is delivered directly to where pain signals travel, intrathecal drug delivery offers significant pain control, with a small fraction of the dose that would be required with pills. This helps minimize side effects. Clinical studies show that of people who did not experience enough pain relief with high doses of oral medication, most achieved significant pain control with intrathecal drug delivery and were able to improve their activities of daily living.


 In The News
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