In spine and back pain problems, various invasive methodologies for managing pain can be employed. Injections, also called ‘blocks’, are one of the ways of pain management wherein, corticosteroids or other numbing drugs are introduced in the ligaments, muscles, or nerves to provide temporary or long-term relief from inflammation and pain. Along with providing pain relief, pain injections are also used to:
- Identify the source of a patient’s back problem
- Determine the areas to be addressed during surgical intervention
- Cope with residual or recalcitrant pain after a surgery
- Rehabilitate a patient after surgery
Spinal pain is most commonly caused due to pinching of nerves, and it is almost always treated with a variety of pain injections depending on the patient’s condition.
Imaging Guided Epidural Injections:
These injections are used to induced steroidal drugs into the epidural region, which contains the nerves and blood vessels of the spine.
Depending on the source and severity of the pain, these injections can be induced as pure steroids, pure anesthetic, or a combination of steroids, anesthetics medication, and saline solution under the guidance or a C-arm or CT imaging.
Epidural injections are typically used to relieve inflammation and pain caused by conditions such as spinal stenosis, foraminal stenosis, disc herniation, or degenerative disc diseases. They provide relief from back pain as well as pain that is radiated to the arms and legs.
Imaging Guided Foraminal Injections:
The spinal nerve roots exit the spinal cord from each vertebra by passing through bony windows known as ‘Foramen’. These nerve roots further extend to form the nerves in the arms, chest wall, and legs depending on the level.
Sometimes, due to herniated discs or bone spurs, these nerves get inflamed and cause severe pain radiating into the arms and legs. In conditions like these, a foraminal injection helps the spine specialist to detect which specific nerve is the root cause of the pain.
This selective root nerve blocking is performed by our back pain specialist in Mumbai as a diagnostic procedure. The doctor injects each individual nerve with an anaesthetic drug and checks if the patient’s pain subsides. Once the patient feels reduced or no pain after a specific nerve is being targeted, that particular nerve is numbed with a mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) drugs. Later, if the injection was effective but pain restarts after a few months, surgery can be done at the same level to give definitive and permanent solutions.
Imaging Guided Facet Block injections:
Also known as facet joint blocks, they are directly induced into a facet joint using a fluoroscopy technique like CT imaging.
Facet joints are pairs of synovial joints that are located between the articular processes of two adjacent vertebrae. They contain a rich innervation of nerves which are often subjected to pinching and systemic diseases like arthritis which cause severe pain and inflammation in these joints.
When facet blocks are induced in these joints, they inhibit the growth of inflammatory chemicals and numb the pain receptors, thereby reducing the pain signals transmitted through the nerves.
These injections serve as an intermediate between medical management and surgical management. If the patient is scared of surgery, they can give a trial of injection to ascertain whether they will get relief and how much relief from pain after surgery. The injections are not very expensive, can be done as a day-care procedure with discharge within a few hours, and costs less than $300-400.