Therapeutic injections are given to treat acute and chronic pain syndromes. They are more effective than an oral medication because they deliver medication directly to the anatomic location that is generating the pain. It may result in permanent or temporary relief from pain. Injections can also be used for diagnostic purposes to guide the most appropriate treatment for the patient. The type of injection required that will give adequate relief to the patient depends upon the nature and location of pain.
Different Kinds of Injections for Pain Relief
- Epidural Steroid Injections: Steroids are powerful anti-inflammatory medications that give excellent pain relief. This technique is mainly related to spine pain and involves injection of medication near the injured area of spine. The effect of pain produced by the compounds in the body is reversed by these medications. Thus the functionality of the structure is improved and pain is lowered. For short-term pain relief, local anaesthesia is used with these injections.
Main indications for Epidural Steroid Injection
- Radiculopathy (spinal nerve irritation)
- Sciatica (lower back irritation)
- Spinal arthritis
- Tumor-related pain
- Intervertebral disc
- Spinal stenosis
- Disc herniation
- Degenerative disc disease
The injection technique can be performed on any part of the spine. Usually three techniques are included:
- Interlaminar Epidural Injections
- Transforaminal Epidural Injections
- Caudal Epidural Injections.
The dosage is generally 1-2 injections for best results that can be noticed within 3-10 days of the procedure.
- Facet Joint Injections: The inflamed facet joints causes severe neck and back pain. The pain is usually experienced in the spine between the two vertebrae. The facet joint injections are used to diagnose and control these pains. They numb the source of pain and soothe the inflammation for the patient. If the first injection gives pain-relief to the patient, then this process can be repeated 3 times a year. But if no results were obtained then further process would also not yield any specific result. Usually the results are temporary ranging for few days to years.
- Medial Branch Nerve Block Injections: This technique can be used to diagnose and treat facet joint pain. The sensations of facet joint are controlled by medial branch nerve. The injection along with local anaesthesia is injected into the medial branch nerve to control the pain sensations. If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient’s pain. It has the advantage of giving faster and immediate pain relief. The results become evident in 10-20 minutes after injection.
- Sacroiliac (SI) joint injections: A sacroiliac (SI) joint injection or block is used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction. An injection along with cortisone and local anaesthetic is injected into the affected area. This causes a feeling of numbness in that area and in turn patient feels relief from pain. This confirms that the pain is originating from sacroiliac (SI) joint. It may also control the pain for a short-period of time thus serving a dual purpose of diagnosis and therapeutic.
Advantages of Injections for Management of Pain:
- Provides immediate pain relief
- Helps in diagnosis and confirmation of the real cause of pain
- Can sometimes give permanent relief from pain
- Improves mobility and functionality
- No hospital stay required
- Less harmful than surgical intervention
- No damage to any body structure
- No or minimum recovery time
Dr Manish Vaish - Neurosurgeon
Neurosurgeon NCR, Delhi
Dr. Yashpal Bundela MS Mch
Dr.Girish Rajpal MS Mch FINR
Dr. Shiwani Jain MD FNB
PDFC (Neuro-anaesthesia and Critical care)
Dr Hrishikesh Chakrabartty
Dr.Praveen Kumar MS Mch
Dr. Manish Marda MD DM