The Spinal Injection Procedure
Spinal injection procedures are minimally invasive procedures performed
on the spine/spinal nerves for a specific purpose. These procedures
are performed under x-ray (fluoroscopy) guidance to ensure precise needle
placement and thereby enhance the accuracy of the injection. Some of
the procedures may also involve minor surgery. All of these procedures
are performed under sedation with medications given intravenously.
What is the purpose of spinal injections?
The purpose of injection procedures is to:
1. diagnose or identify the source of pain
2. predict the outcome of another procedure or surgery
3. provide pain relief by decreasing inflammation and swelling
Why do I need a spinal injection for making a diagnosis?
 Diagnostic
spinal injections are used to identify the source of pain. Several structures
in your spine can cause pain. One or more of these areas may be the
source of your pain. As the pain becomes more chronic, it becomes more
complex. It is helpful to think of the spinal injection as a test.
Pain Block X-Ray
There are several possible sources of pain. These are called pain
generators. The challenge is to recognize the source(s) of pain from
several potential sites and treat it. Sometimes, a routine evaluation
in the clinic is not enough to make a specific diagnosis. Therefore,
X-rays, CAT scans or MRI are obtained to see if there are changes in
the spine. These studies will pick up a herniated disc, evidence of
nerve compression and arthritic changes in the spine. However, presence
or absence of these changes does not always mean that this is where
the pain is coming from. Some pain generators can look normal on imaging
studies, while some abnormal findings can be completely painless.
One way to identify pain generators is by injecting and numbing a selected
area with a local anesthetic and steroid and then assessing for any
changes in pain response. Your doctor will examine you, study your X-rays
and make a list of areas that will need an injection. You will probably
need more than one injection to localize the source(s) of your pain.
The areas will be injected one at a time. You will fill out a pain log
for 2 weeks after each injection. This will help your doctor see how
much pain you had following the injection. The results from these diagnostic
injections will help in deciding which areas need further treatments.
This process helps in establishing a diagnosis and guiding future treatments.
In some cases, however, the source of pain may not be established despite
this exhaustive exercise. In such situations, the blocks help in eliminating
the areas suspected to be the source of pain.
Learning more about the cause of your pain can help your doctor decide
on the best treatment for you.
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