Q.  What are spinal injections?
A.  Spinal injections are procedures in which a doctor injects medicine into a part of the spine or in an area near a nerve root.

We provide fluoroscopic guided injections for chronic pain sufferers. We have a new state of the art C-Arm as well as full X-Ray services and can provide SI, Epidural, Facet, Translaminar, Transforaminal, Lumbar injections, as well as other procedures. We can treat a new referral within one week!

Q.  What are spinal injections?
A.  Spinal injections are procedures in which a doctor injects medicine into a part of the spine or in an area near a nerve root.

Q.  Why are the injections done?
A.  When more traditional treatment has failed, a spinal injection could help. Injections can not only treat problems with the spine but also assist the doctor to establish the diagnosis.

Q.  How do the injections help the doctor establish a diagnosis?
A.  One of the difficulties in treating people with back pain is that there are numerous structures that can be "sick" and generate pain. These pain generators may not always be obvious during an exam or even an imaging study such as an X-ray or MRI. Successful treatment depends upon the identification of the pain generator. The medicine injected into the spine includes a numbing medicine similar to the medicine a dentist uses. If the injection into a part of the spine suspected to be a pain generator relieves your pain even temporarily, the pain generator has been found. Appropriate treatment can often follow.

Q.  So the injection finds the pain generator. Once the medicine wears off I'm in the same spot right?
A.  Not necessarily. Only one of the medicines injected is a numbing medicine. The numbing medicine is mixed in a syringe with an anti-inflammatory medicine, usually a steroid. The steroid is responsible for decreasing the inflammation in that area. If successful, long lasting relief can follow and often does.

Q.  My aunt had steroids for lung disease. She is very ill from complications of the steroids. Will I get sick from the steroids in the spine injections?
A.  Although in rare cases, some people respond negatively to spinal injections the amount of steroid placed specifically in one tiny area of the spine is tremendously less than the steroids people take in pill form. Also, the injections are limited in number whereas people who take oral steroids usually take these medications daily. It is important to remember that although oral steroids have side effects, they are often the only treatment available to treat certain diseases.

Q.  If I get spinal injections, will the steroids make me muscular or grow hair?
A.  No. the steroids that do those things are a different type of steroids.

Q.   Are injections the answer to my back pain?
A.  Only your doctor can answer that question. It is unusual for one or a series of injections to be curative. In most cases injections are just one aspect of treatment which could include Physical Therapy, exercise and a healthy diet.

Q.  What conditions can be helped by injections?
A.  The conditions that can be helped include arthritis of specific joints of the spine and pinched nerves.

Q.  Which joints could be involved?
A.  In my practice the most commonly involved joints which benefit from injections include the facetjoints (small, paired joints on the posterior spine), sacroiliac joints (large joints on either side of the sacrum) and the joints between the vertebrae themselves which contain the discs.

Q.  How are spinal injections done?
A.  Since the joints in the spine are usually narrow and small, most of them can only be entered with confidence if the doctor uses an imaging machine to localize the needle tip. Special X-ray machines or CT scans can confirm the location of the needle tip before the injection occurs. This not only increases effectiveness but safety as well. Some doctors safely perform a type of spinal injectioncalled epidural steroid injections without CT or X-ray guidance. Others prefer to use a special X-ray machine.

Q.  I have had back pain for years. A doctor gave me epidural steroid injections in the past and they didn't help. Could these other injections help me?
A.  It is possible that they could. Epidural steroid injections are specific for certain types of back problems but not all of them. Often, an epidural steroid injection may be of no benefit, then a facet or sacroiliac joint injection may help tremendously. With injections and all procedures, a correct diagnosis combined with effective treatment usually results in improvement or recovery.

Q.  Are there procedures done by doctors other than these injections that are designed to reduce back pain?
A.  Yes. Doctors with special training and equipment can use devices to deactivate the tiny nerve branches that transmit the sensation of pain.

Q.  How would I know if I am a candidate for injection therapy?
A.  Candidates meet most of these criteria:

1. They have pain that has not responded to more conservative treatment (Physical Therapy, medicine, spine mobilizations).
2. A specific pain generator has been identified and it is treatable with an injection.
3. There are no medical reasons to avoid an injection.

Q.  I feel that an injection may help me. How can I be evaluated for this?
A.  Ask your doctor or request a referral to a medical doctor who performs these procedures.