If you are living with severe or chronic back pain that hasn’t responded to conservative treatment approaches, such as activity modification or physical therapy, it may be time to explore the possibility of spinal injections for back pain management. A spinal injection is a minimally invasive procedure that, for many patients, significantly reduces back pain while improving mobility, function, and quality of life. Spinal injections don’t typically cure the underlying cause(s) of back pain, but they can be used to pinpoint the precise location where it originates in the spine and manage debilitating symptoms.
We’ve provided an overview of seven of the most common types of spinal injections below:
Benefits Of Injections For Back Pain
At the New Jersey Spine Institute, we have the privilege of seeing the positive impact that spinal injections make in the lives of our patients on a daily basis. Some of the benefits of injections for back pain include:
- Non-surgical – For many patients, spinal injections offer an effective and non-surgical alternative to spine surgery. Most injection procedures take less than an hour to perform (some significantly less), and very little downtime is required afterward. Patients can typically resume their normal activities within 1 to 3 days after treatment. While generally considered safe, risks such as infection, bleeding, and nerve damage do exist with spinal injections. Speak with your doctor or spine specialist to learn more.
- High Success Rates – While the success rates for back pain injections vary depending on a variety of factors, including the cause and location of the pain, the type of injection administered, and the number of injections administered over time, a large percentage of patients experience short-term symptom relief after receiving a spinal injection. A 2015 study found that the response rate to epidural steroid injections was 72% for patients with low back pain and radicular leg pain due to lumbar disc herniation.
- Improvements in Mobility, Function, and Quality of Life – Spinal injections can be instrumental in helping patients get back to the lifestyle and activities they love—whatever those may be. From elite-level sports to mowing the lawn, spinal injections can help you get back to moving in all the ways you need throughout the day.
Epidural Steroid Injections (ESI)
Epidural steroid injections (ESIs) are administered directly into the epidural space—the area between the vertebrae and the spinal cord’s protective covering. They contain a combination of an anesthetic (which calms irritated nerves and reduces pain over the short term) and a long-lasting corticosteroid (which reduces inflammation and relieves pressure on compressed nerves over the long term).
Epidural steroid injections can be administered between the flat bone plates of the vertebrae (interlaminar), via the openings in the vertebrae where nerve roots exit the spine (transforaminal), or via the sacrum to reach the lowest nerves in the back (caudal).
Conditions Commonly Treated With Epidural Steroid Injections
Epidural steroid injections are generally used to treat pain and other symptoms stemming from nerve irritation and/or compression. These commonly include:
- Bulging or herniated discs
- Sciatica
- Spinal stenosis
- Degenerative Disc Disease
What To Expect
During an epidural injection procedure, you can expect the following:
- The injection site will be prepped and cleaned, and you’ll receive a local anesthetic.
- Contrast dye will be injected. The dye is visible under X-ray and will be used in combination with fluoroscopic (real-time X-ray) guidance to ensure the needle is precisely placed within the epidural space.
- A combination of steroid medication and anesthetic will be injected into the epidural space.
- A bandage will be applied, and you’ll be monitored for a short period of time in case side effects or complications arise.
Epidural steroid injections can provide back pain relief for weeks to months, and sometimes even longer.
Radiofrequency Ablation (RFA)
Radiofrequency ablation (RFA) is classified as an injection procedure because it involves the insertion of a needle into the body, but unlike epidural steroid injection, it does not involve the delivery of medication to the spine. Rather, during an RFA procedure, a specialized needle with an electrode that gives off radiofrequency energy is used to precisely target, heat, and destroy nerve tissues. This process disrupts the nerve tissues’ ability to transmit pain signals to the brain and can provide significant pain relief as a result.
Conditions Commonly Treated With Radiofrequency Ablation
Radiofrequency ablation is often used to target pain originating from the facet joints, particularly in cases where other forms of treatment have been unsuccessful. Conditions commonly managed with RFA include:
- Facet joint arthritis
- Degenerative Disc Disease
- Spinal stenosis
- Sacroiliac joint pain
What To Expect
RFA is typically performed under local anesthesia using fluoroscopic or ultrasound guidance. Most patients can resume normal activities within 24 hours after treatment. The effects of RFA often last for between 6 to 12 months.
Sacroiliac Joint Injections
The sacroiliac (SI) joint is located where the sacrum (the triangular bone at the base of the spine) meets the ilium (the upper portion of the hip bone). Sacroiliac joint injections deliver medication (usually a mixture of local anesthetic and corticosteroid) directly into the SI joint and can provide substantial pain relief.
Conditions Commonly Treated With Sacroiliac Joint Injections
Sacroiliac (SI) joint injections may help relieve low back pain caused by:
- Inflammatory arthritis
- Sciatica
- Spinal traumas or injuries
- Sacroiliac joint dysfunction
What To Expect
The procedure for an SI injection is very similar to that for an epidural steroid injection (ESI). Patients can usually return to their normal activities within approximately 24 hours after treatment. The effects of SI injections can last anywhere from a few weeks to a few months, depending on the circumstances.
Selective Nerve Root Block (SNRB)
A selective nerve root block (SNRB) is a highly targeted spinal injection that can be used to manage nerve pain in the back or pinpoint its source. Anesthetic (and sometimes steroid medication) is injected around a specific nerve root, temporarily interrupting pain signals to the brain.
Conditions Commonly Treated With Selective Root Nerve Block Injections
SNRBs are commonly used to diagnose and manage pain associated with the following conditions:
- Bulging or herniated discs
- Sciatica
- Bone spurs
- Spinal stenosis
- Scoliosis
What To Expect
The procedure for an SNRB injection is similar to that for an epidural steroid injection (ESI). According to a 2020 study, 29% of patients experienced pain relief for at least six months after a single SNRB injection.
Regenerative Injections
Regenerative injections, such as stem cell therapy and platelet-rich plasma (PRP) injections, harness the body’s own natural healing processes in order to regenerate, regrow, and strengthen damaged tissues over time. Stem cells or platelets may be harvested from the patient’s body and injected into the targeted area at a higher concentration to trigger and speed healing responses.
Conditions Commonly Treated With Regenerative Injections
Conditions commonly treated with regenerative injections include:
- Arthritis of the spine
- Spinal traumas or injuries
- Herniated discs
- Sacroiliac joint pain
- Facet joint pain
- Degenerative Disc Disease
What To Expect
Regenerative injections usually require the harvesting and processing of cells or tissues prior to injection. Learn more about the efficacy of platelet-rich plasma (PRP) injections for lower back pain and stem cell injections for back pain here. It’s important to note that regenerative injections are still being researched for back pain and that outcomes may vary widely. Speak with your doctor or spine specialist for more information.
Facet Joint Injections
As their name suggests, facet joint injections are administered directly into the facet joints, the hinge-like joints that connect the vertebrae at the back (posterior) of the spinal column. Like EPIs, facet joint injections deliver a combination of local anesthetic and corticosteroid that can help relieve and manage back pain. In some cases, facet joint injections can also be administered for diagnostic purposes.
Conditions Commonly Treated With Facet Joint Injections
Some conditions commonly treated with facet joint injections include:
- Arthritis of the spine
- Degenerative Disc Disease
- Spinal traumas or injuries
- Spinal stenosis
- Ankylosing spondylitis
What To Expect
The procedure for a facet joint injection is very similar to that for an epidural steroid injection. Recovery usually takes 1 to 2 days, though recovery times can vary based on the patient’s condition and individual health factors. Pain relief may last anywhere from several weeks to several months, depending on the circumstances.
Medial Branch Blocks
Medial branch blocks precisely target specific medial nerves (small nerves that branch out from the facet joints) in order to interrupt pain signals to the brain. They are used primarily for diagnostic purposes and frequently followed by treatments such as facet joint injections and/or radiofrequency ablation once the irritated nerve has been pinpointed.
Conditions Commonly Treated With Medial Branch Blocks
Medial branch blocks may be used to diagnose facet joint pain stemming from:
- Arthritis of the spine
- Degenerative Disc Disease
- Facet joint inflammation
- Scoliosis
- Ankylosing spondylitis
What To Expect
A medial branch block typically only relieves pain for a few hours, though relief can last for up to a few days, depending on the circumstances. Patients can usually resume regular activities within 1 to 2 days following this type of injection, but will often require further injection treatments, such as facet joint injections or radiofrequency ablation, to manage back pain over the long term.
New Jersey Spine Institute Will Help You Avoid Surgery Through Minimally Invasive Techniques
At the New Jersey Spine Institute, Dr. Dwyer and Dr. Vessa specialize in administering spinal injections for back pain management. Whether your healthcare provider has recommended spinal injections or you’re simply curious if they could be a suitable treatment option for your needs, we’re here to answer your questions and develop a personalized treatment plan tailored to your health goals and the specifics of your case.
Contact our New Jersey spine surgeons to learn more today! We look forward to working with you.