Back Pain Injections

When medications and other nonsurgical treatments fail to relieve chronic back pain, doctors may recommend injections for pain relief. Following are some of the most commonly used injections, although some are of questionable value

Nerve Root Blocks - Nerve Block Therapy

If a nerve is inflamed or compressed as it passes from the spinal column between the vertebrae, an injection called a nerve root block may be used to help ease the resulting back and leg pain. The injection contains a steroid medication and/or anesthetic and is administered to the affected part of the nerve. Whether the procedure helps or not depends on finding and injecting precisely the right nerve.

Facet joint injections

The facet joints are those where the vertebrae connect to one another, keeping the spine aligned. Although arthritis in the facet joints themselves is rarely the source of back pain, the injection of anesthetics or steroid medications into facet joints is sometimes tried as a way to relieve pain. The effectiveness of these injections is questionable. One study suggests that this treatment is overused and ineffective.

Trigger point injections

In this procedure, an anesthetic is injected into specific areas in the back that are painful when the doctor applies pressure to them. Some doctors add a steroid medication to the injection. Although the injections are commonly used, researchers have found that injecting anesthetics and/or steroids into trigger points provides no more relief than “dry needling,” or inserting a needle and not injecting a medication.

Prolotherapy

One of most talked-about procedures for back pain, prolotherapy is a treatment in which a practitioner injects a sugar solution or other irritating substance into trigger points along the periosteum (the tough, fibrous tissue covering the bones) to trigger an inflammatory response that promotes the growth of dense, fibrous tissue. The theory behind prolotherapy is that such tissue growth strengthens the attachment of tendons and ligaments whose loosening has contributed to back pain. As yet, studies have not verified the effectiveness of prolotherapy. The procedure is used primarily by chiropractors and osteopathic physicians.