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Cervical, Thoracic and Lumbar Treatments

When back pain won’t go away, your doctor may include injections to ease your back pain and inflammation. These shots usually consist of a steroid and a local anesthetic.

While these shots help some people, not everyone gets the same relief. Back injections may help treat two major back pain problems:

  • Inflammation or damage to a nerve, usually in the neck or the low back. Called radiculopathy, the issue originates where the nerve exits the spine. Sharp pain shoots from the lower back down into one or both legs, or from the neck into the arm. A herniated disk can be the cause.
  • Spinal stenosis, or narrowing of the spine. Stenosis can happen because a herniated disk is pressing on the spine or because a bone spur is jutting into the spine. Less common, it can be caused if a tumor presses on the spine. No matter the cause, spinal stenosis compresses the nerves inside, causing pain in the buttock or leg. You also may have back pain. The pain from spinal stenosis may get worse when you’re active, and ease up when you lean forward.

Doctors use injections for other types of back pain as well. Sometimes they are used to help find what's causing the pain.

What Happens During an Injection?

There are several kinds of injections, including:

  • Epidural Steroids
  • Nerve block
  • Discography

Epidural injections include a steroid medicine, also called a corticosteroid, and usually an anesthetic medicine. The effects of epidural shots can offer modest to complete pain relief. They can often provide both short and long-term (greater than 6 months) relief.  Conservative therapy is often recommended for the first 4-6 weeks as long as the pain is not incapacitating.

In a nerve block, a doctor injects the area around the nerve with an anesthetic. Lidocaine is the anesthetic most commonly used. After a nerve block injection, you’ll have numbness with near-complete pain relief. It wears off after several hours. Corticosteroids may be added in hopes that it will provide longer term relief.

In discography, the disc is pressurized using fluid via a direct injection. The goal is to elucidate pain identical to the patient’s routine pain. The procedure is controversial because of its highly subjective conclusions. False positive and false negative results are common.

Possible Side Effects

Mild soreness or pain at the site after an injection is common. Headache, nausea and vomiting may also occur. It’s rare, but injections can cause bleeding or infection.