At Coastal Spine, surgery to relieve pain should always be the last treatment option. That’s the goal of our pain management strategies. But sometimes physical therapy or ongoing use of oral pain medication isn’t working. In these cases, injections may be effective.
Injections can provide longer lasting relief from pain and inflammation than oral medications, and they don’t have the same risks of addiction and other side effects.
Here’s some information on two injections we use at our five Coastal Spine locations, along with a description of the corticosteroid usually used.
Cortisone, also known as corticosteroid, is the most common injected material because of its anti-inflammation characteristics.
People confuse corticosteroids with anabolic steroids, but they are not the same thing. Corticosteroids simply work to reduce inflammation. They don’t have the testosterone effects of anabolic steroids. Lidocaine is mixed with the corticosteroid to provide instant pain relief before the steroid fully gets to work calming inflammation.
Unfortunately, cortisone injections can’t reverse or stop the progression of damage from osteoarthritis. Also, they can be used as a long-term solution because they can contribute to cartilage damage.
When dealing with pain caused by bulging or herniated discs or from spinal stenosis, our team often uses epidural corticosteroid injections. These are delivered into the epidural space, the area that surrounds the dura, a membrane that covers the nerve roots in the spine. When the nerve roots are exiting the spine, they pass through the epidural space, and they can be impinged by bulging or herniated discs or from a narrowing of the space due to spinal stenosis.
When administering these cortisone injections, our doctors use x-ray guidance and local anesthetic. These injections can provide pain relief for several months, even longer in some cases.
Trigger Point Injections
Trigger points are small, hypersensitive knots in the muscle tissue. The pain can surround the area or can radiate to other parts of the body. They are common in the back and shoulders in patients with myofascial pain syndrome and fibromyalgia. We usually inject local anesthetic first, as these injections often need to be delivered more deeply.