Introduction
Spinal injections have emerged as a definitive intervention in pain management. Continuous advancement in the medical field improve patient care and outcomes. The human spinal cord is the anatomical structure that can be affected due to several diseases. The spinal disorders can be spinal stenosis (narrowing of the spine), herniated discs (the fluid between the vertebrae protrudes), and joint arthropathy (joint damage). These disorders cause severe pain. Several treatment approaches have emerged to treat pain, which includes a minimally invasive procedure, like spinal injections. These are the treatments of choice when conservative treatment does not respond. These can be used for the detection of pain sources, such as leg, neck, arm, or back pain, and as a treatment procedure to relieve pain. The article discusses spinal injections, types, procedures, benefits, and side effects.
What Are Spinal Injections?
Spinal injections are minimally invasive medical procedures in which the medication is loaded in a syringe and directly injected into or around the spine area to provide pain relief. These are commonly indicated for people with spinal disorders, nerve irritation, and chronic pain conditions. Spinal injection is sometimes included in an exercise program to maintain spinal stability and mobility.
What Are the Different Categories of Spinal Injections?
There are several types of spinal injections. Spinal injections aim to manage pain and inflammation and diagnose the location of pain and spinal conditions. The common types of spinal injections are as follows:
1. Epidural Steroid Injections: These injections were discovered in 1930 to treat sciatica. In 1970, it was described for managing low back pain and needle placement. These are commonly used to relieve pain and inflammation in the spinal area. The medications, such as corticosteroids and local anesthetics, are loaded and directed into the epidural space in these injections. There are three types of epidural steroid injections.
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Caudal Epidural Steroid Injections: These injections are injected at the underneath part of the epidural space to relieve pain.
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Interlaminar Epidural Injections: This is indicated in the case of a herniated disc and spinal stenosis and injected between two vertebrae.
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Transforaminal Epidural Injections: This is injected into the epidural space, where the spine bends towards the body. This helps in finding the root cause of nerve pain.
Indications: The indications of epidural steroid injections are as follows:
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It is indicated to reduce inflammation in the case of herniated discs. These can cause nerve compression and pain.
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People with narrowing of the spinal cord can go for this injection to relieve nerve compression.
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These types of injections are indicated in the case of Degenerative Disc Disease (intervertebral discs wear and tear) to manage pain.
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The sciatic nerve pain can be diagnosed by using this type of injections.
Procedure:
The patient is asked to lie on the operating table. The local anesthesia is injected into the affected site. Fluoroscopy is then used to inject epidural steroid injections. The injection is then loaded with corticosteroids and injected at the epidural space. After injecting medications, the person may get relief from pain within weeks or months. Post-injection, the patient is monitored to check for any side effects before being discharged. The effectiveness of the injection may vary from person to person.
Side Effects:
These types of injections are safe but may carry some risks, such as nerve damage, bleeding, allergic reaction, and infection.
2. Facet Joint Injections: These are the injections in which corticosteroids and local anesthetics are used and injected at the spine's facet joints. These are used to manage pain and inflammation.
Types:
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Medial Branch Block: In this type, the injection is used for a diagnostic purpose and is injected at the medial branches of nerves, which supply the facet joint to find the pain source.
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Intra-Auricular Block: This type is for the management process. The injection is loaded with medications and is injected at the facet joint.
Indications:
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The inflammation of facet joints can cause pain in the joints. These injections are used to alleviate pain.
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In the case of facet joint syndrome, the person may experience pain, irritation, discomfort, and inflammation at the affected joint.
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These types of injections are indicated in the case of neck and back pain, and the healthcare provider suspects that the pain originated from the facet joints.
Procedure:
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The patient is asked to lie on the table with face down. The local anesthetic agent is used to numb the injection site. Then injection is loaded with corticosteroids and a local anesthetic agent for immediate pain relief. The person may get relief within weeks or months. After the injection, the patient is closely monitored to check for allergic reactions.
Side Effects:
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The risks include pain, bleeding, infection, and allergic reactions.
3. Radiofrequency Ablation: The electric current is used to manage pain during this procedure.
Indication:
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Chronic back pain.
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Neck pain.
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Peripheral nerve pain.
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Arthritis-related pain.
Procedure:
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The patient is positioned on the operating table. The local anesthetic injection is given to numb the area. The specialized needle with an electrode is used to guide the target nerve. The radiofrequency currents are passed to form heat and form a thermal lesion on the nerve. People may get pain relief within several months. After the procedure, the patient is advised to stop strenuous activities temporarily.
Risks:
The risks include infection, nerve injury, allergic reaction, and bleeding.
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Sacroiliac Joint Injections: These injections diagnose and treat pain related to the sacroiliac joint. The joint is present in between the pelvic area and spine.
Indications:
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Dysfunction of sacroiliac joint.
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Chronic lower back pain.
Procedure: The patient is positioned on the operating table. The local anesthetic agent is injected. The fluoroscopy or thin needle is used to guide the procedure. The combination of corticosteroid medication and the local anesthetic agent is injected into the sacroiliac joint. This can be used for diagnostic and treatment purposes. The person may get pain relief within several weeks to months.
Side Effects: The risks include bleeding, infection, and allergic reaction.
4. Sympathetic Nerve Blocks: Regenerative therapy injections are injected into the spine to control involuntary body functions. These functions include sweating, blood flow, and digestion. These are commonly indicated in the case of neck and lower back pain.
5. Regenerative Therapy Injections: These types of injections are for the natural healing process. Different types of regenerative therapy injections are used for the healing process.
Types:
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Platelet-rich plasma (patient's blood is taken; from that, platelets and growth factors are concentrated and injected into the target area. These are indicated for musculoskeletal injuries and soft tissue injuries).
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Stem cell therapy (cells are formed from patient bone marrow and adipose tissue. These are indicated in case of tissue injuries and joint degeneration).
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Amniotic fluid injections (during childbirth, the amniotic fluid is obtained, which is used to repair support tissues and decrease inflammation).
Conclusion
In conclusion, spinal injections are used to relieve pain and inflammation. These are generally safe and effective but are associated with some risks. The risks can be infection, bleeding, and allergic reactions. The person may get immediate pain relief or may get relief within weeks or months. The advancement in regenerative medicine revolutionizes treatment options that create the innate capacity of the body to repair.
