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Spinal injections

Epidural steroid injections are the most common type of spinal injection. However, there are a number of different types of injections available (see below).

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Everything you need to know

If you’re looking into spinal injections as a way to manage back pain, it’s good to know that there are several types of spinal injections, which are commonly used. These injections can be used to manage pain, reduce inflammation, or to help diagnose a spine condition. These are some of the most common types:

  1. Epidural steroid injections. These help relieve pain in the back and in the areas near the spinal nerve roots. Sometimes, they can also be used to reduce arm or leg pain. They are often used to help manage pain caused by a herniated disc, spinal stenosis, or radiculopathy.
  2. Facet joint injections. The facet joints connect the bones of the spine. Nerve roots pass near these joints and connect the spinal cord to peripheral nerves. This injection works by injecting a mixture of local anaesthetic and steroid (an anti-inflammatory) into the facet joints in your spinal canal. It may be recommended if you suffer from arthritis or other conditions of the facet joints.
  3. Medial branch nerve blocks: This is a test to see if your neck and back pain is caused by your facet joints. In a medial branch block, your doctor will inject local anaesthetic over the nerves in your facet joint. If this relieves your pain, it will confirm the facet joints are the source of your pain.
  4. Radiofrequency ablation (aka radiofrequency denervation): This procedure involves putting a needle into the nerves by the facet joints in your back. Radiofrequency waves are then used to damage the nerves to reduce your pain.
  5. Sacroiliac joint injections: The sacrum is the large bony part at the base of the spine. This injection can be used to diagnose and treat certain types of lower back pain. A mixture of local anaesthetic and steroid is used, which will help reduce pain in the joint as well as tackle surrounding inflammation.

Before the procedure

Spinal injections are performed on an outpatient basis, which means you can be treated and go home the same day. There are no special preparations for this procedure. You can eat and drink and take most medications as normal.

However, if you take blood thinning medications, such as Warfarin, Clopidogrel, Rivaroxaban, Dipyridamole or Dabigatran, please let us know before you come in for your injection.

During the procedure

When you arrive, we will guide you to our imaging department, as injections are administered using real-time x-ray guidance. We will ask you some questions and monitor your vital signs. After you have signed a consent form agreeing to the procedure, we will take you to the treatment room and ask you to lie down on a bed on your stomach.

The doctor will then clean the skin, so it is ready to be injected with local anaesthetic. Once the area is numb, your doctor will guide a needle into your back to target the source of your pain. This will be done under X-ray guidance in real time.

Once the needle is in place, your doctor will inject medication into the target area.

The whole procedure should only take 15 – 30 minutes to complete.

After the procedure

After the procedure, you may find that your legs feel numb, weak, floppy or tingly, but this should pass after a few minutes. Our team will take you to a separate room to recover, where you will be able to have some food. Our nurses will also monitor your blood pressure. Once you’re ok to leave, you should be collected and taken home as you won’t be allowed to drive.

When you get home, you should take it easy and rest. You should be able to return to work the next day.

Your consultant will give you specific instructions to follow, which might include keeping a pain diary. It might take up to 6 weeks for your pain to go away, so you need to be patient and follow all guidance to ensure you make a speedy recovery.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.