Steroid Injections for Back Pain
Back Pain Treatments in the Larger San Francisco Bay Area
Corticosteroids, commonly just called “steroids”, are synthetic drugs designed to reduce inflammation in muscles and tissues. A steroid injection can serve as a temporary, long-term treatment for back pain. This nonsurgical procedure only takes a few minutes, and the results last for several months.
There are four main types of steroid injections for back pain:
- Epidural Injections: This is an injection for the spinal canal that surrounds the spinal cord. It is commonly used to treat sciatica.
- Trigger Point Injections: An injection for muscles in the back to reduce inflammation and pain in the back, hip, or legs.
- Facet Joint Injections: The facet joints are the joints that connect vertebra to one another. This injection can reduce inflammation and pain in the back.
- Sacroiliac joint injection: The sacroiliac joints are the joints that connect the pelvis to the spine. This injection can reduce inflammation and pain in the sacroiliac joint.
If steroid injections successfully treat your pain, they can prevent the need for surgery. Additionally, pain relief from steroid injections can allow you to perform new back strengthening exercise in physical therapy. This can potentially prevent the need for surgery altogether.
Steroid injections for back pain at a glance:
- Steroid injections insert corticosteroids into the back. Corticosteroids are designed to replicate anti-inflammatory hormones.
- There are three main types of steroid injections that are classified based on where they are injected into the spine.
- Steroid injections may reduce pain and restore mobility.
Risks & Side Effects of Steroid Injections
Steroid injections are one of the most effective ways to decrease pain and improve function. In addition, it’s important to keep in mind that not everyone gets the same level of relief from the injections.
Since the amount of steroid injected is usually small, injections may be repeated up to three times per year if necessary with no significant side effects. Common side effects include:
- Muscle tensions
Types of steroid injections offered at MOS
We treat patients in the Bay Area with lower back (lumbar), neck (cervical) or sciatica pain (hips, buttocks and legs) using epidural steroid injections and sacroiliac joint injections.
Epidural steroid injections
Epidural steroid injections are injected above the dura, the outer most layer covering the spinal cord and the nerves exiting the spinal cord.
Conditions that can cause acute or chronic back pain that can be treated by steroid injections include:
- Lumbar disc herniation
- Degenerative disc disease
- Lumbar spinal stenosis
- Cysts in the facet joint, the nerve root that can expand to spine structures
- Annular tear, tear in the outer disc
This treatment option can give relief from one week up to one year. If proven successful, a patient may have up to three epidural steroid injections in one year.
We perform this procedure in our offices or at surgery centers. The patient will lie down on his or her stomach, and the orthopedist will use a local anesthetic to numb the area around the injection site.
Using fluoroscopy, which involves real-time, moving X-rays, the surgeon guides the needle to the correct location, then injects the steroid mixture. Once the needle is removed, the patient will be monitored for a short time before being discharged. Patients are asked to rest for the remainder of the day and can use an ice pack at the needle insertion site if it is feeling tender.
A temporary increase in pain can occur for several days after the injections due to the pressure of the fluid injected or a chemical irritation. Only a very few patients report a spinal headache after the procedure; this is due to a dural puncture that occurs in 0.5 percent of injections. It usually goes away in a few days, but infrequently a blood patch is needed to alleviate the headache.
Sacroiliac Joint Injection
Sacroiliac joint injections, also known as sacroiliac joint blocks, are primarily used to diagnose or treat lower back pain and sciatica symptoms associated with sacroiliac joint dysfunction. Pain in the lower back and legs can be caused due to too much or too little movement in the sacroiliac joints. The two sacroiliac joints are located next to the spine and connect the spine with the hips.
The typical injection procedure will begin with the patient lying face down and the injection site is numbed. Under X-ray or ultrasound guidance, the doctor will place the needle into the sacroiliac joint, confirm the placement and then inject a small amount of anesthetic with a corticosteroid.
The anesthetic is used for the diagnostic portion of this injection. If the pain is eliminated, then we learn that this area was the pain generator and we have been able to diagnose sacroiliac joint pain. Then the corticosteroid reduces the inflammation, which is usually the cause of the pain, and that is the therapeutic portion of this treatment.
After the procedure, the patient will stay at the doctor’s office for a 30-minute observation period and is then released to go home and rest.
To schedule an appointment for back pain treatment at Muir Orthopaedic Specialists, contact us today. We serve Walnut Creek, San Ramon, Brentwood, and Concord.