A spine injection is a nonsurgical treatment modality recommended for the treatment of chronic back pain. Injection of certain medicinal agents relieves pain by blocking the nerve signals between specific areas of the body and the brain. The treatment approach involves the injection of local anesthetics, steroids or narcotics into the affected soft tissues, joints or nerve roots. It may also involve complex nerve blocks and spinal cord stimulation. The different types of spine injections include:
- Proliferation injection: Proliferation injection is also known as sclerotherapy and is a non-surgical treatment for musculoskeletal injuries. It involves injecting a dextrose solution (irritant) into the damaged or injured ligaments and tendons. Macrophages, the defence cells of the body, reach the site of injection to attack the irritant. Meanwhile, the body brings in fibroblasts that heal the damaged ligaments and form connective tissue. This injection helps in the proliferation of new cells and the repair of connective tissue.
- Neural prolotherapy: In neural prolotherapy, an irritant solution is injected into the painful areas where the ligaments and tendons are injured. This irritates the local area, causing inflammation. The macrophages arrive at this site to dispose of the irritant. This encourages the repair process where the fibroblasts, produce connective tissue. The release of growth factors at the site of injury may help in strengthening and reducing the pain, inflammation and weakness.
- Lumbar epidural: This spinal injection is administered to help relieve low back and leg pain. The injection usually contains a steroid, and may sometimes include a local anesthetic or normal saline to treat inflammation. You will be placed on your stomach and the skin at the site of injection cleaned and numbed with a local anesthetic. The doctor then administers the lumbar epidural injection under the guidance of fluoroscopy. This is an outpatient procedure, and you will be discharged on the same day.
- Facet injections: This is an office-based procedure performed to diagnose the cause and location of pain experienced, as well as relieve the pain caused by injury or diseases of the facet joints. A local anesthetic and/or steroid are injected into the facet joint to block the pain. Pain relief following the injection confirms the source of the problem. The injection of a steroid reduces inflammation and provides long-term relief.