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Spinal injections

Injections are sometimes offered as a treatment for back pain. If you're having an injection for back pain, you'll have a local anaesthetic and a steroid injected into or close to your spine. Injections in or near your spine can help deliver pain relief directly to the source of your pain and discomfort.

About injections for back pain

Injections into or near your spine deliver pain-relieving medicines directly to the source of your pain. They can help ease back pain or sciatica (shooting pain down one or both of your legs). Injections do not always help, but they can be very effective when everything else has failed. How long an injection will help ease your pain for can vary, but it may last several months or longer.

There are two medicines used in injections for chronic back pain. A local anaesthetic is used to block pain from the injected area. Steroids are used to reduce swelling and irritation (inflammation) in the injected area. Usually a mixture of the two is injected at the same time.

There are three main injection techniques for treatment of back pain:

  • Caudal Epidural injection. This targets the space that surrounds the nerve roots in the lower lumbar spine and can be used to help with disc-related pain. More information about caudal epidurals can be found here.
  • Nerve root block injection. This targets individual nerves in your spine.
  • Facet joint or sacroiliac joint injection. This targets the joints that link the bones of your spine.

Caudal epidural injections and nerve root block injections help ease sciatic pain so you can progress with rehabilitation. The type of injection you have will depend on your specific symptoms and the reason for having the injection.

What happens during an injection for back pain?

The injection point will be carefully selected and then the injection site will be sterilised . A local anaesthetic will then be injected under the skin. This means you shouldn't feel the injection needle going into your back too much.

The needle with then be carefully inserted into your back. Once it has reached the correct place, you may feel some discomfort. While the needle is being inserted, it's important that you don't move because any movement makes positioning the needle more difficult. 

Once the needle is in the correct position,  local anaesthetic and steroid are injected into the spine. Afterwards,  the needle is withdrawn and the injection site is covered with a plaster.

What to expect afterwards

If you have a caudal epidural or a nerve root block, you may experience some temporary numbness or weakness in your legs, but this will pass quickly. Your blood pressure will be monitored for about 30 minutes after you’ve had the injection and you’ll be able to go home when you feel ready.

Recovering from an injection for back pain

It's best to take things easy for the first 24 hours. After this, your back may start to feel sore because the steroids can take a few weeks to work. If there has been no improvement in the first two weeks, this does not necessarily mean that the injection has failed. The steroid component of the injection acts over a long time, and there can be a delay of a few weeks before your back pain or sciatica starts to improve.

It's important to remember that injections aren’t a cure for back pain, and that physical therapy such as osteopathy may be necessary to help improve your condition in the long-term.

What are the risks?

As with every procedure, there are some risks associated with injections for back pain. These include side-effects, or complications:

1) Side-effects

Side-effects are the unwanted but normally temporary effects you may get after having a procedure. There are a number of possible side-effects of an injection for back pain, including:

  • Pain and tenderness in your back or leg. 
  • High blood sugar levels. If you have diabetes, you will be asked to keep checking your sugar levels when you get home. 
  • Weakness in the legs
  • Feeling dizzy or faint.

2) Complications

Complications are when problems occur during or after a procedure. Complications of an injection for chronic back pain are rare, but include:

  • Bleeding. 
  • An infection, which may require antibiotic treatment.
  • Temporary loss of feeling.
  • An allergic reaction, such as a rash or itching.