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 Non-Operative Treatment: Therapeutic Injections

The physicians at the San Diego Center for Spinal Disorders (SDCSD) understand that pain management is a high priority for most patients with spinal disorders. To help manage your pain, your physician may prescribe a therapeutic injection, such as nerve blocks, epidural steroid injections, and radiofrequency nerve ablation. These procedures may help to relieve and control pain from degenerative disc disease, injury, osteoarthritis and other disorders of the spine.

Nerve Blocks
A nerve block is an injection of medication onto or near nerves. The injected medication may include a local anesthetic, steroid or narcotic.

Epidural Steroid Injections
The epidural space is the space surrounding the membrane that covers the spinal cord and nerve roots. Disorders such as spinal stenosis and herniated disc can cause nerve irritation, inflammation, and pain. An epidural injection places anti-inflammatory medication (e.g. steroids) into the epidural space. Epidural injections are performed in the cervical, thoracic and lumbar spine.

Sacroiliac Joint Injection
The sacroiliac joint is the largest joint. It is located in the lower spine above the tailbone, and normally has very little motion. Inflammation of the sacroiliac joint can cause low back and buttock pain. An injection of an anesthetic and steroid may help relieve joint pain.

Radiofrequency Nerve Ablation
Facet joints are one source of back pain. Radiofrequency nerve ablation uses radio waves to produce heat focused at a specific facet joint nerve. The heat destroys the nerve and relieves pain.

The ablation procedure is similar to a nerve block or spinal joint injection except two needles are inserted; each facet joint has two nerves. Fluoroscopic guidance is used to correctly position each needle. Then radiofrequency "radio waves" are directed through each needle. The ablation process takes about two minutes. The entire procedure takes about 2 hours.

Patient Restrictions
For safety, some patients are not allowed to undergo a spinal injection for the following reasons:

If therapeutic injections for pain management are not an option for you, our staff will discuss other pain management strategies such as medication or physical therapy.

Patient Preparation: At Home
The staff at SDCSD will thoroughly prepare you for any injection therapy, and it is important to follow all pre-test instructions. These instructions generally include:

Patient Preparation: At the Medical Facility

What to Expect During the Procedure

After the Procedure

Possible Complications
Spinal injections, like other medical procedures, have risks. Complications include risk of infection, low blood pressure, headache, and injury to nerve tissue. These risks are low.

Conclusion
We perform the full range of injection therapies to provide the best possible pain management for your condition. The skilled medical team at SDCSD will carefully discuss the options with you, and we'll give you detailed instructions for before and after the procedure so that you are well prepared.

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