Pain Management

What You Should Know About Spine Injections

spine injections: How does it function? Is it appropriate for me? Is it going to hurt? Get answers right here.

If your pain persists despite rest, physical therapy, and other conservative treatments, but you’re not quite ready for surgery, spinal injections can be a great intermediate back pain treatment. To put it mildly, the idea of a needle in the back is unappealing to many people.

We understand you have concerns about the spinal injection procedure, and we have answers for you. Here’s how to tell if you’re a good candidate, what to expect from the procedure, how to prepare, and other information.

What medical conditions could prevent me from receiving an injection?

Getting a spine injection is a personal decision that should be made in consultation with your doctor. Your provider can explain the procedure’s risks and benefits, as well as recommend appropriate, evidence-based injection options based on your conditions, preferences, and other factors.

There are few absolute disqualifying conditions. They are as follows:

  • New-onset pain thought to be the result of trauma, cancer, or infection
  • Spinal cord or cauda equina (a bundle of nerves in the lower back) compression causing progressive neurological deficits

Among those for whom the risks may outweigh the benefits are those who:

  • suffer from poorly controlled diabetes 
  • suffer from severe bleeding disorders
  • Have a compromised immune system

A recent infection or severe allergy to a medication contained in the injection could also disqualify you. To avoid radiation exposure, pregnant women may choose to have a spinal injection after delivery.

Do I need to consult with another doctor?

Unless you are going to have the injection under sedation, you are unlikely to need medical clearance from your doctor. The doctor will determine whether you are a good candidate for anesthesia.

Do I need to discontinue my blood thinners?

Most of the time, you will be asked to discontinue your blood-thinning medication prior to the injection. You may be asked to discontinue your medication anywhere between 6 hours and 10 days before the procedure. Within 24 hours of the injection, you should be able to resume using the blood thinner.

The decision to discontinue your blood thinner medication is influenced by a number of factors, including:

  • Blood thinner type
  • Why are you prescribed a blood thinner
  • The type of injection you’re getting

You, the injector, and the doctor who prescribed the blood thinner should all be involved in deciding how to manage your blood thinning medication prior to the injection.

What other medications must I discontinue?

Aside from blood thinners, you should take your medications as usual, with a small sip of water. Nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen and naproxen) and aspirin should be avoided before certain spinal injections, particularly those involving the cervical spine, because they can increase your risk of bleeding. Before the injection, discuss with your doctor whether you want to take NSAIDs or Aspirin.

Is a spine injection painful?

Spine injections can be uncomfortable, but they are usually well tolerated. In most cases, the physician performing the spinal injection will numb the area where the injection will take place with a local anesthetic, similar to how dentists numb a patient’s teeth with an injection prior to beginning a procedure.

Sedation may be used in some cases of spinal injections. Sedation can be administered orally or intravenously. The most commonly used class of sedatives is benzodiazepines. When deciding whether to use sedation with a spinal injection, consider the type of spinal injection, the length of the procedure, your overall health, and your preferences.

Is it necessary for me to stop eating and drinking?

If you will be sedated, you must stop eating and drinking 8 hours before your procedure. Fasting instructions for spinal injections performed without sedation vary slightly. Some centers do not require fasting, while others require you to refrain from eating or drinking after midnight on the day of your injection.

What do I need to bring to my spine injection?

Please bring your insurance card as well as a photo ID. Wear loose-fitting, comfortable clothing. Bring your diabetic medication to the appointment if you have it.

What should I leave at home?

Your valuables should be left at home. Young children should not be brought to the appointment because they will be unable to enter the procedure area with you.

Is it necessary for me to have someone drive me home after a spine injection?

You will need to have someone drive you home unless you are having a trigger point injection. Trigger point injections are typically performed using dry needling or local anesthetic with no sedation, so you should be able to drive yourself home. Some facilities require your driver to accompany you to the procedure and remain in the waiting room until it is completed.

What exactly occurs during the spinal injection procedure?

You may be asked to change into a gown after checking in. Prior to the procedure, it is usually a good idea to use the restroom. The operation will be carried out on a table that allows you to lie comfortably on your stomach or side. The majority of injections are carried out with the assistance of an X-ray machine located above the table.

An antiseptic solution will be used to clean the skin around the injection site. To numb the area, local anesthetic medication will be injected into and around the injection site. Your spine specialist will insert a needle into the predetermined spinal region once the local anesthetic has taken effect. A contrast dye and an X-ray will be used to guide the needle to the correct location. The medication, which is typically a combination of a local anesthetic and a steroid, will then be gradually administered.

What happens after the spine injection procedure?

After the procedure, you will be monitored to ensure that you are not experiencing any side effects from the medication. You will be given discharge paperwork and follow-up instructions. It may take a few days for the injection to fully take effect. It is possible that you will be asked to keep a pain diary in order to record your reaction to the injection.

Are there any restrictions on your activities after the procedure?

For the rest of the day, you should avoid strenuous activity and driving. After 24 hours, you should be able to resume your normal activities.

Can I shower after the procedure?

Most doctors will let you shower the same or next day. Swimming in a bath, pool, or hot tub is usually permitted 24 to 72 hours after the injection.

You’ve gained knowledge and had your questions answered. Are you ready to book your spinal injection? Find a spine specialist in your area who can assist you.

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