Spinal Disc Pain Injection Procedures

Back pain is a common health complaint. The University of Washington Medicine website estimates that up to 80 percent of American adults have experienced such pain at some time in their lives. It can be triggered by an injury to the spine or may be the result of a disorder such as osteoarthritis, herniated disc or spinal stenosis. Injections into spinal discs in the area of discomfort can provide temporary relief, as well as vital diagnostic information.

Pinpointing Pain Source

• Whether you are consulting an orthopedist or a pain management specialist for your back or neck pain, the first order of business will be to obtain X-rays or magnetic resonance images (MRI) of the area of the spine that seems to be the source of your pain. Such images, particularly the MRIs, provide doctors with a look at areas where discs show abnormalities that indicate deterioration or traumatic injury. These images also offer an inside look at areas where nerves exiting the spinal column are being impinged upon by the vertebral structure.

Diagnostic Value of Injections

• Although the X-rays or MRIs may seem to indicate one or more discs that may be causing the problem, no definitive conclusions can be drawn from these images alone. Your doctor probably will suggest that you have a spinal disc injection in an attempt to confirm whether the suspected disc or discs are causing your pain. An injection that relieves your pain is considered a positive diagnosis that the disc is at least partially responsible for your pain. If multiple discs are injected and no relief is produced, your doctor may suggest that other areas of the spinal structure, such as facet joints, be injected to see if relief can be obtained through those means.

Injection Procedures

• The general heading for most spinal injection procedures is the epidural steroid injection (ESI), according to the website of the Mayfield Clinic. The three injection techniques that fall under the ESI heading are caudal block, transforaminal and translaminar. Each of these techniques describes the approach the doctor takes when injecting the spine. The preparation for each is basically the same. You lie face down on a table, and the area around the injection site is sterilized, after which a local anesthetic, such as lidocaine, is administered to numb the area. Using fluoroscopy for guidance, the doctor injects a needle into the target area, delivering a strong corticosteroid to the site. The entire procedure takes only 10 to 15 minutes, after which you will be observed briefly before being released to go home.

Techniques

• In a caudal block ESI, the needle is injected into the caudal canal at the base of your lumbar spine, according to the All About Back Pain website. For a translaminal, or translumbar, ESI, the needle is inserted into the epidural space between two of your vertebrae, while in the transforaminal ESI, the injection is made close to a nerve root as it exits the spinal canal and vertebra through an opening called the foramen.