Spinal Injections for the Management of Back Pain
Back pain is so common in the UK that figures have shown 1 in 7 GP consultations are for musculoskeletal problems. Whilst most people will suffer mild and/or short-term bouts of pain, many will need to seek treatment.
At One Healthcare, we have a team who specialise in the treatment of back pain and sciatica. Treatments include physiotherapy, injection therapy and spinal surgery. The type of spinal injections offered is tailored to each patient’s individual needs.
Spinal injections are mainly used for diagnostic or healing purposes. A diagnostic spinal injection may help your surgeon to plan the long-term management of your condition by understanding the cause of the pain. A therapeutic spinal injection uses local anaesthetic and steroids to improve your symptoms and reduce any swelling and/or inflammation.
Spinal injections work by delivering medication into or close to your spine, typically around the cause of the pain. There are two medicines used in spinal injections, local anaesthetic, which offers immediate relief, and steroids. The local anaesthetic is used as a blocker to shield the pain from the injected area. The steroid is used to minimise swelling and inflammation. A successful spinal injection may relieve your pain for up to 3 months.
Most common amongst these spinal injections are facet joint injections, epidural injection’ and nerve root blocks. Injections can help relieve pain and inflammation but also help your Consultant learn more about your specific pain.
Facet Joint Injections
The facet joints allow your back to be flexible and enable you to bend and twist. They are in almost constant motion and as such, it is very common for them to degenerate and contribute to back pain. Injections may be recommended by your Consultant specialist to relieve pain and inflammation in your facet joints and they may be used to assess your suitability for facet denervation treatment.
You may also need to see a physiotherapist to help address the causes of the pain.
An epidural injection typically contains steroids, anaesthetics and anti-inflammatory medications and is used in the space around the spinal cord, also called the epidural space. They are used to reduce inflammation and relieve pain. Epidural injections can be used in different areas along the spine depending on your individual pain issues.
Nerve Root Blocks
Sciatica (trapped nerve pain) is often caused by compressed or irritated nerves in our spines and in those cases, your Consultant may recommend a type of injection called a ‘nerve block’ to ease this pain. These injections are highly selective and can often help patients avoid more invasive surgery.
Medial Branch Blocks
Medial branch blocks are very similar to facet joint injections, working in the same way but given in different parts of the joint. A combination of local anaesthetic (which helps numb the pain) and a steroid (which helps reduce the swelling).
With a medial branch block, the local anaesthetic and steroid are injected over the nerves in to your facet joint, which send pain signals to your brain. This will temporarily stop the pain signals being carried by the nerve, alleviating the painful symptoms.
Sacroiliac Joint Injections
Sacroiliac joint injections, also known as sacroiliac joint block are mainly used to either diagnose or treat lower back pain and/or sciatica symptoms linked with sacroiliac joint dysfunction. It is used for pain in certain contained parts of the body where other techniques and practises have not worked. The injection goes in to a joint at the bottom of the spine where it joins the pelvis known as the sacroiliac joint. Sacroiliac joints sit next to the spine and link the sacrum to the hip on both sides.
Radiofrequency Denervation (also known as Facet Rhizolysis, Radiofrequency Ablation or Radiofrequency Neurotomy).
Radiofrequency denervation targets neck or back pain that originates in your facet joints. Not everyone finds radio frequency useful, if you’ve been offered the procedure, it is important to make the right decision for you.
The radiofrequency denervation procedure is carried out with the patient under local anaesthetic. The tip of a needle is heated with radiofrequency waves and inserted into your back, which is then used to destroy the nerve endings. Radiofrequency works by sending waves to disable the nerves (medial branch nerves) around the facet joints that are causing pain in your back or neck.
Stellate Ganglion Block
A stellate ganglion block is an injection of local anaesthetic to block the nerves situated on either side of the voice box. This injection typically targets pain in the neck, head, chest or arm. If you find stellate ganglion blocks helpful and effective, your doctor may recommend a series of injections to help maintain long term pain relief.
Costotransverse Joint Injections
Costotransverse and costovertebral joint injections are both used to block pain. They work by injecting medication into the small joints where the ribs join with the spine at the top of the back. Costotransverse joint injections are used to confirm that these joints are the cause of the upper back pain as well as to deliver pain relief.
Rare Complications of Spinal Injections
Spinal infections are rare, affecting approximately 1 in 100 patients, though potentially serious. Treatment involves an intense course of antibiotics in hospital.
Injections can lead to bleeding or bruising, causing discomfort and pain or, if you are on a course of blood thinning medicines, an epidural haematoma (a localised collection of blood around your spinal nerves).
You may be left with a dull headache, caused by your spinal cord leaking fluid due to the spinal needle puncturing the outer covering of the cord. This pain is not considered serious and is remedied by lying flat for three days after treatment.
Spinal Nerve Injury
This can lead to numbness or weakness of the legs or bladder/bowel dysfunction, and is caused by the spinal needle coming into contact with the nerve sheath during a root injection or discography.
The treated area may sometimes become painful or sore. This is usually temporary, lasting only a few hours or days, but should be monitored nonetheless as an extended period of pain may be a sign of infection.
Symptoms usually appear immediately and most are treatable there and then, causing no permanent harm. Signs of an allergic reaction after leaving the hospital should be brought to the attention of your doctor.
At One Healthcare we can book you in to see a specialist Orthopaedic Consultant or Pain Management specialist for an initial consultation, usually within 48 hours. Spinal injections are available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.
You can use your private medical insurance or pay for your Spinal Injections treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.
Why One Healthcare
- Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
- Fast access to diagnostics including MRI, Xray and Ultrasound
- Private, spacious, en-suite rooms
- Specialist Physiotherapy and nursing teams
- Little or no waiting time
- ‘Ultra clean air’ theatres
- Freshly prepared food
- Calm, dignified experience