Back pain injections include epidural steroid injections, facet joint injections, sacroiliac joint injections and others

Several types of injections can be used to diagnose and treat back pain. In many cases, injections are used for both purposes at the same time. Alternatively, some patients receive an injection with a purely diagnostic or therapeutic intent.

How injections can diagnose and treat spinal problems

There are many nerves and joints in close proximity within the spine. While imaging scans can sometimes reveal which nerve or joint is affected, this is not always the case. When used to diagnose neck or back pain, injections can help determine if a specific nerve or joint is the source of a patient’s discomfort.

During a diagnostic injection, advanced X-ray technology (fluoroscopy) is used to guide the placement of a needle into a specific area. If a diagnostic injection provides immediate pain relief, this indicates that the nerve or joint that was injected is pinched or inflamed.

When used as a form of treatment, back pain injections deliver medications directly to a problematic part of a patient’s spine. This option may be a beneficial if oral medications alone do not produce the desired results. Typically, the injections contain a combination of an anesthetic (numbing) medication and a corticosteroid medication, which mimics cortisol, the body’s natural anti-inflammatory hormone.

Types of back pain injections

The main types of injections that are used to diagnose and treat spinal conditions include:

• Trigger point injections — Target trigger points, or painful points in tense muscles that have developed into knots
• Epidural steroid injections — Placed directly into the epidural space of the spine
• Selective nerve root block (SNRB) injections — Placed in one specific nerve root in the neck or back
• Facet joint injections — Target a specific facet joint in the spine (commonly used to diagnose or treat arthritis or facet syndrome)
• Sacroiliac (SI) joint injections — Placed into the sacroiliac joint, which is located at the very bottom of the spine between the sacrum and the pelvic bone

While it’s only necessary to diagnose a condition once, therapeutic injections can sometimes be provided in a series. Depending on a patient’s needs, two or three back pain injections may be performed over the span of several months. Therapeutic injections are usually used along with physical therapy, stability exercises, oral medications or lifestyle changes.