Injection Treatments

The bones that make up the spine are called vertebrae. Each vertebra has a hole in it, and when vertebrae are arranged in the spine, these holes line up to form a tunnel called the spinal canal. The spinal canal has a special sac called the dura which contains the spinal cord. Branching off the spinal cord and passing through gaps in the spine are the nerves that both transmit sensory information (including pain) to the brain and signals to the muscles in the body.

The seven vertebrae at the top of the spine are cervical vertebrae. They support the neck and head. The five vertebrae at the base of the spine are lumbar vertebrae and make up the lower back. These vertebrae are responsible for supporting the weight of the torso.

Pressure on nerves emanating from the spine or other spinal issues may be the cause of pain and discomfort for a patient. The injection of anti-inflammatory medicines at different points in the spine can improve symptoms and often lead to successful treatment programs and healing.

Additional Information

The Spinal Column
Cervical, Thoracic and Lumbar Interlaminar Epidural Injections

Cervical Epidural Steroid Injection

Pressure on nerves at the top of the spine (cervical vertebrae) may cause inflammation (irritation and swelling). Thus, neck pain (as well as some pain that may be felt in the head or arms) could be caused by an inflamed nerve passing between cervical vertebrae.

If the source of pain is suspected to be caused by nerve inflammation, the physiatrist may suggest a Cervical Epidural Injection. With this treatment, medication is injected into the neck into the epidural space near the spine. The injection can help relieve pain and soreness and may enable the physiatrist to find the source of pain.

Facet Joint Injection

Facet joints are joints between the vertebrae of the spine where the bones contact each other and are joined by ligaments and connective tissue. These joints function to provide stability and mobility. Facet joints are in the neck (cervical), upper back (thoracic) and lower back (lumbar).

Back or neck pain may be caused by facet joint problems such as arthritis of the spine, back injury, or mechanical stress to the back. In these circumstances, the facet joints have become inflamed (swollen and irritated).

To help with the pain, the physiatrist may recommend a Facet Joint Injection. When a facet joint injection is performed, a steroid medication is injected into the inflamed joints. The steroid can anesthetize the facet joint and block the pain. These injections can also help the physiatrist diagnose the cause of the pain by finding problem joints.

Lumbar Epidural Steroid Injection

Pressure on nerves in the base of the spine (lumbar vertebrae) may cause inflammation (irritation and swelling). This may be the cause of some lower back pain or leg pain.

If the source of a patient’s pain is suspected to be caused by nerve inflammation, the physiatrist may suggest a Lumbar Epidural Injection. With this treatment, anti-inflammatory medicine is injected into the back into the epidural space near the spine. The injection can help relieve pain and soreness and may enable the physiatrist to find the source of your pain. Also, by reducing inflammation, the underlying injury causing the pain may be able to heal.

Sacroiliac Joint Injection

The sacrum is a triangular-shaped bone that supports the spine above it, connects to the coccyx (tail bone) below it, and joins with the left and right hip bones. The two sacroiliac joints are what connect the sacrum to the hip bones. Inflammation or dysfunction of this joint can cause pain in either the low back area or be the cause of sciatica (low back pain that includes the buttock and extends down one leg).

The Sacroiliac Joint Injection is two-fold and used to diagnose the source of low back pain or sciatica as well as provide pain relief.

The diagnostic injection numbs the sacroiliac joint with a local anesthetic. If the patient experiences significant pain relief, a diagnosis of sacroiliac joint dysfunction is made.

A therapeutic injection is used to provide relief from pain using a steroid medication (anti-inflammatory) using the same procedure used for the diagnostic injection. If the therapeutic injection succeeds in reduction or elimination of the patient's pain, it may be repeated up to three times in a year along with a recommended program of physical therapy and rehabilitation.