Types of Spine Injections

Spine Injections are chosen based on the presentation of Back pain. After careful evaluation from your history, examination and MRI scan you will be offered the best possible choice.
You will be able to get back to work or leisure with these injections followed by physiotherapy. Early intervention and treatment can prevent further damage to the spinal nerve

Steriod and local anaesthetic in Spine Injection

Spine Injections
Spine Injection contains a local anaesthetic. It is a numbing solution that blocks the pain

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Mangattil Rajesh is a Consultant Spinesurgeon in London

Mr. Mangattil Rajesh

Consultant Spine Surgeon, Royal London Hospital
Whitechapel, London.

I am a Consultant Spine Surgeon at Royal London Hospital, London. My experience is from the extensive training in Spine Surgery from surgical rotations in London and from further 3 Spinal Fellowships at Manchester, North Tees and at Royal London Hospital in the UK and advanced training in France and USA.

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Frequently Asked Questions

Spine injections with steroid do not cause any serious long-term side-effects. But having too many injections in one area can cause the surrounding tissues and the joint cartilage to weaken and breakdown. The skin and soft tissues below at the site of the spine injection also thins out. Due to repeated steroid injections, the ability of the tissues in the spine to fight injections infections will be reduced. This raises the risk of infections.

It is recommended that we limit the number of Spain injections for low back pain to 3 or 4 per year at any one particular site on the spine.

No Spine injection procedure is without its risks and complications. These are very rare and occasionally there are reports of:

INFECTION: This is rare but there is an increased risk in skin conditions like psoriasis or eczema. The rate is less than 1 in 1000 injections

BLEEDING: There is very little chance that you will bleed from a tiny puncture wound with a needle. But there is an increased risk of bleeding if you are taking medications to ‘thin your blood’ like warfarin, rivaroxaban or clopidogrel. You will be advised to stop these medications at least a week in advance of the procedure for safety.

ALLERGIC REACTION TO THE CONTRAST DYE: In rare instances, you may be allergic to the dye that is used to check the exact needle position. This happens in the range of 1in 200 to 1 in 500 injections. People who are allergic to seafood are found to be more prone to this reaction. These include skin rash, itching and flushing of the face.

HEADACHE: This happens when there is a small leakage of the fluid present around your spinal cord from the injection. This fluid usually leaks out and can cause headache while standing and walking for a few days. You will be advised to lie down flat for a few days until the headache settles.

FASCIAL FLUSHING: This is a temporary side effect from the steroid injection and settles down very quickly.

VASOVAGAL OR FAINTING EPISODE: This can be due to the stress of the procedure and is not life threatening. 1 in 100 patients do have such episodes and it settles very quickly.

Spine injections for herniated disc is a very safe procedure. The Spine injection is very carefully placed and under Xray control after sedation. This allows accurate placement of the needle very close to the spinal nerve and therefore the injection is delivered exactly around the site of inflammation of the nerve and the surrounding tissues. A contrast today is used to check the position of the needle under x-ray control and the steroid with local anaesthetic solution is injected around inflamed nerve and soft tissues.

This improves the margin of safety and reduces the errors in needle placement. The risks and complications of this procedure like infection, bleeding and nerve damage are kept to the very minimum.

As soon as you have injection, you will find immediate relief of pain in the back. This is because of the local anaesthetic solution used in the injection. This is the fluid that numbs your mouth when you go to the dentist. The effect of this numbing injection wears off in about 3 to 6 hours. You will be given pain medication to be taken before the effect of this injection wears off.

Your will stay in the hospital for four hours until you are safe to go home. You will be discharged home with clear instructions about when and how to take those pain medications.

As the steroid injections takes time to work on the inflammation of the nerve and the surroundings soft tissues, You will feel the pain coming back before the for a brief period of time before the steroid takes effect. Mild stretches and gentle physiotherapy is allowed during this time. It will improve mobility of your spine and increase the strength and tone of your muscles. You will get maximum benefit from physiotherapy after these injections.

Spine injection is a mixture of steroid and local anaesthetic. Kenalog is a Steroid commonly used in Spine Injections. It has a 40 mgs of steroid in a sterile solution. This steroid works on the nerve root as it comes out of your spine and reduces pain and inflammation around them.

It blocks the release of chemicals that your body releases from ruptured or damaged discs, injured soft tissues around your spine. Steroid limits the production of proteins needed for these chemicals and supresses the painful nerve signals coming from these injured tissues. In addition, the local anaesthetic gives immediate pain relief and the steroid takes 24 to 48 hours to act on the inflammation.

The steroid and local anaesthetic in combination works very well. Due to the pain relief, there is more movement in the small (facet) joints and the soft tissues. This increase in movement will further reduce the stiffness around the bones, ligaments and muscles of your spine.

Spine injection relieve your pain instantly due to the local anaesthetic effect of the numbing solution. When you go to the dentist this local anaesthetic works immediately to get to relief from your pain. In the same way, your backpain will also be relieved immediately. However, this effect goes off in 24 to 48 hours. You’ll be given medication to go home with so that you don’t feel the pain coming back.

In the meantime, the steroid injection works on the inflamed nerve and soft tissues of the spine. This gives a longer duration of pain relief. Generally the pain relief varies from a period of 6 weeks to 6 months. Physiotherapy rehabilitation is advised along with the spine injection. The combination of spine injection and physiotherapy will offer you relief from your back pain for more than six months.

Yes, they do certainly work. As you know the spine injection is a mixture of steroid and local anaesthetic. Kenalog is the Steroid commonly used in Spine Injections. It has a 40 mgs of steroid in a sterile solution. This steroid works on the nerve root as it comes out of your spine and reduces pain and inflammation around them.

It works by blocking the chemicals that your body releases from ruptured or damaged discs, injured soft tissues around your spine. Steroid limits the production of proteins needed for these chemicals and supresses the painful nerve signals coming from these injured tissues. In addition, the local anaesthetic gives immediate pain relief and the steroid takes 24 to 48 hours to act on the inflammation.

The steroid and local anaesthetic in combination works very well. It also allows you to have physiotherapy rehabilitation so that there is more movement of your spine and soft tissues. This reduces the stiffness and spasm of the back and controls low back pain.

No, it does not hurt. This procedure is done under sedation with the help of a very experienced anaesthetist. He will make sure that you do not feel any pain during the entire procedure. You will wake up refreshed and free from pain. After the intial anesthetic wears off, you may feel the pain coming back. But do not worry. We will give you medications to go home so that you do not feel the pain after the  effect of the local anesthetic solution wears off.

In the meantime, the steroid injection acts on the inflammed nerves and soft tissues. It also blocks off all the pain signals that come from the spinal nerve and soft tissues.

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