There are a variety of procedures which can be performed to help alleviate the symptoms of back pain. A few of these include Epidural Steroid Injections, Facet injections, and Nerve Root Blocks.
Epidural Steroid Injections
MIIGS doctors use fluoroscopy to help guide the needle into the epidural space, and the medicine is injected directly into the epidural space. Controlled studies have found that medication is misplaced in 13% to 34% of all epidural injections that are performed without fluoroscopy.
An epidural spinal injection (ESI) may be performed when one or more nerve roots are effected or if the pain is on both sides of the back or leg. With an ESI the steroid is injected directly into the epidural space. The epidural space is the area that surrounds the spinal cord and the nerves coming out it. A small needle is guided into the epidural space under fluoroscopy guidance. This guidance greatly increases the success of the procedure over traditional non imaging guided techniques. The injections are usually performed in sets of three, with each injection occurring one week apart.
Facet Joint Injections
The injection of local anesthetic and steroids into the facet joint is diagnostic and potentially therapeutic. Pain relief following a precise Intra-articular injection confirms the facet joint as a source f pain. The injection of steroids provides longer pain relief. Long-term relief (approximately 6 months) can be obtained in 50-70% of patients.
Nerve Root Injections
Nerve root blocks are useful to diagnose and treat back pain. Nerve root blocks can be used to anesthetize the desired nerve for diagnostic and therapeutic purposes. Once the symptomatic nerve root is known, targeted steroid injections are used in an attempt to produce long-term relief, primarily in patients with radiculopathy.
Multiple causes of radiculopathy have been discovered. It is usually the result of pressure on or inflammation around the nerve root. This causes pain within the nerve root, which is referred along the course of the nerve (radiculopathy). Because steroids have an anti-inflammatory action, injections around the nerve root may reduce inflammation, thereby decreasing or eliminating the pain.