Injections can be quite useful in treating a wide variety of pain conditions. They can help the provider determine what is causing your pain and then treat it by placing a local anesthetic and an anti-inflammatory medicine into the location where the pain is thought to be coming from.
Injections are grouped by the type of tissue or the location they are designed to treat.
Joint injections are used to relieve pain related to bursitis—an inflammation of a fluid-filled sac that acts as a kind of shock absorber around a joint. There are two other kinds of joint injections: facet joint and sacroiliac joint injections. Facet joints are located between the vertebrae in the spinal column, and the sacroiliac joint is located in the very low back where the end of the spinal column joins with the pelvis. There are tissues and nerves in these joints that can become inflamed due to injury or degenerative changes (arthritis), and injections can help relieve that pain.
For pain usually associated with spinal issues, epidural injections may be used. The provider places medication near the spinal column where the nerve roots are located to relieve pain in the neck, shoulders, back, or legs. Epidural injections are used for such conditions as spinal stenosis, herniated disc, or degenerative disc disease (arthritis).
These are used to help diagnose the underlying cause of neck or back pain. The provider places medication where they believes the pain is coming from, and if it is relieved they know they have located the source of the pain. This is sometimes necessary because pain is often referred from its actual source to other areas of the body, making it difficult to always know with precision where it is coming from.
Providers may use trigger points to treat small, localized contractions in muscle tissue that can produce a wide band of pain, often in the back or shoulders. These small contractions pull on the tendons and ligaments associated with the muscle resulting in pain in distant areas not immediately associated with that muscle.
How Injections Work
The provider normally combines two medications in these injections: a local anesthetic and a steroid. The local anesthetic often provides almost immediate relief but it is short acting; the steroid acts more slowly but provides much longer-lasting relief. Once the local anesthetic wears off (3-12 hours), your pain will return or even get a little worse at first. This is normal and expected. Once the steroid is fully absorbed and begins to reduce the swelling and inflammation that is contributing to your pain, your pain will start to subside.
Treatment usually consists of a series of three injections over a period of about six weeks, depending on the underlying condition and the patient’s response to treatment. Injections using steroids are generally limited to about three in a six month period to minimize any potential side effects of the medication.
Injections performed under X-ray guidance by an experienced physician are extremely safe. Potential complications, including infections, bleeding, nerve injury, or headache could happen, but they are highly unlikely.
There are no known long-term side effects from a series of injections, but if you are diabetic your blood sugar level may rise for several days to a week after the injection. People with diabetes should take precautions to ensure their blood sugar is well controlled before getting a pain injection.