Injections

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Spinal Injections

An injection is a way of getting medicine or other fluids into the body by a method other than the digestive system. In the United States injections into the subcutaneous layer of skin or the muscle are often called “shots” and in UK English they are often referred to as “jabs.”  The medication or other fluid is injected into the body using a syringe and a sharp hollow needle which pierces the skin and the tissues to the appropriate depth.

Several different problems in the spine result in “nerve pain.” This is a sharp pain that travels along the pathway of a certain nerve or nerve root. The nerve root is the part of the nerve that exits the spine. An example of this is a sciatic pain. Nerve pain can often be relieved by an injection to help anesthetize or numb the nerve and to decrease the inflammation which is often the reason for the pain.

Other patients without nerve pain have generalized inflammation that causes chronic pain. Injections into the spine can successfully decrease the inflammation in most of these patients.

For example, if a patient has low back pain that runs down his leg, it might be caused by an inflamed disc. The swollen disc is pinching the nerve that travels down his leg. If the swelling and inflammation in the disc are reduced by an injection, with the help of physical therapy, the patient’s pain might be relieved.

Types of Injections

There are two types of these injections:

  • Epidural Injections: These injections are given on an out-patient basis; you will be able to return home on the same day. You will be given a local anesthetic to make the procedure more comfortable but you will remain awake. The doctor uses an x-ray to ensure the correct placement of the needle and the procedure usually only takes 20 to 30 minutes. Your symptoms may get worse for a day or two following the epidural, but by the fifth day after the injection, you will notice the effect. The effects may be very brief, or they may last for several days or weeks. 
  • Local Blocks:  These injections are also performed using a local anesthetic and they are an outpatient procedure. They can be used to diagnose a problem by blocking pain from one area in order to determine exactly which area of the spine is responsible for the pain. They can also be used to help decrease inflammation, which is often the cause of back pain.    

Sometimes repeated injections are necessary after some time has elapsed if the inflammation comes back. This is especially true when the underlying cause of the inflammation has not been treated, for example, obesity.

Patients who are receiving spinal injections can usually be given a sedative if needed to help make them more comfortable during the procedure.

Pre-Operative Advice

You will need to stop eating at midnight the night before your surgery and remain NPO (nothing by mouth) until after your surgery. Surgeons vary on how soon before surgery you should stop drinking water, so you will receive instructions about this and also about whether to take your morning medications.

  • Please do not smoke on the day of your operation or procedure
  • Please bathe or shower the morning of your surgery and do not apply makeup, lotions or powders. Be sure to remove any nail polish.

Post-Operative Advice

Following the procedure, you will stay in the recovery room for a short time. Then you will be transferred back to the outpatient surgery area or your room and be given something to eat and drink. You will stay at the hospital for a few hours to make sure your condition is stable.

After you have been sedated or given a light anesthetic, you will not be able to drive, so you will need someone to pick you up and take you home. It is also recommended that someone stay with you during the first 24 hours following your procedure. Be sure to drink plenty of liquids and eat lightly.

Other instructions after a spinal injection:

  • Do not drive or operate heavy equipment
  • Do not drink any alcohol
  • Avoid making any significant decisions. Your thinking and logic skills may continue to be affected by the sedative you were given for 24 hours.
  • Do not take any sleeping pills or medicine that makes you sleepy. For example, Benadryl.

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