Almost 80 percent of people with chronic neck, back and associated radiating pain, will improve with conservative care such as chiropractic care or physical therapy. But if you’re part of the 20 percent that suffer from chronic back pain that won’t quit, your doctor may suggest alternative treatment options to help manage your pain.
Known as interventional pain management, injections that usually consist of a steroid and numbing agent, can often provide relief. Performed by trained interventional pain management specialists such as anesthesiologists and physiatrists, these shots can be done on their own or in conjunction with chiropractic care or physical therapy.
There are different types of injections that can target the area that causes your pain. Spine pain generators include:
Muscle pain: Muscles can contract and knot up, which are referred to as trigger points. Trigger points can cause both localized and radiating pain and are almost always seen with a chronic spine condition. Trigger point injections into the muscle can relieve this type of pain.
Joint pain: Joints can become injured, inflamed, or arthritic, causing pain in the neck or back. Your spine has approximately 24 vertebrae which are connected to each other by hinge-like joints, commonly referred to as facet joints. Facet joint injections of anesthetic into the suspected joint, often referred to as blocks, can be used to help diagnose as well as treat pain affecting these joints by providing temporary relief while confirming if that joint is in fact the pain generator.
Nerve Pain: Epidural injections are another type of injection that often help people with herniated discs and spinal stenosis, causing compressed nerve roots. These are safe injections of steroid near the spinal nerve that is inflamed and can provide relief by reducing the inflammation. This treatment is a good addition to physical therapy or chiropractic care because it lets you engage in active exercise and therapy to rehabilitate your spine condition.
While these injections help some people, not everyone gets the same relief. Every patient is different, but in most cases, relief can last many months. Getting an injection may give your body enough time to allow your back to heal, or it may let you postpose, or even avoid surgery. If you have back pain that travels down your leg that has not responded well to other more conservative therapies, you may be a good candidate for interventional pain management injections. Make sure you talk to your healthcare provider about your options.
David J BenEliyahu, DC, FICC, DABPM, Administrative Director, Back and Neck Pain Center at Mather Hospital.
Brian Durkin, DO, Medical Director, Pain Institute of Long Island.