Ekkapot Jitpun, MD

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Injections for Low Back Pain and Radicular Pain: What you need to know

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3–5 minutes

What are injections for low back pain and radicular pain?
These minimally invasive procedures help manage low back pain and radicular pain by targeting specific sources of pain and inflammation.

They serve both diagnostic and therapeutic purposes:

Diagnostic Indications

  • Epidural Steroid Injections (ESI): To confirm if inflammation in the epidural space or around the nerve root is causing pain.
  • Medial Branch Blocks (MBB): To diagnose facet joint pain caused by facet arthropathy by temporarily numbing the medial branch nerves that supply the facet joints.

Therapeutic Indications

  • Epidural Steroid Injections: Used for conditions such as:
    • Herniated or bulging discs
    • Radiculopathy (nerve root compression)
    • Sciatica
    • Spinal stenosis (narrowing of the spinal canal)
    • Degenerative disc disease
  • Medial Branch Blocks: Used to treat pain arising from facet joint arthritis (facet arthropathy), which often causes localized low back pain or neck pain, especially with movement or prolonged sitting/standing.

Types of Steroid Injections for Low Back Pain

  1. Epidural Steroid Injections (ESI):
    • Target the epidural space to reduce nerve inflammation.
    • Commonly used for radicular pain caused by nerve root compression.
  2. Transforaminal Injections:
    • Focus on specific nerve roots exiting the spine.
    • Often used for diagnostic purposes to identify the precise nerve causing pain.
  3. Caudal Epidural Injections:
    • Administered to the lower part of the spinal canal to address widespread low back and leg pain.
  4. Interlaminar Epidural Injections:
    • Placed between two vertebrae to treat broad inflammation or pain.
  5. Medial Branch Block (MBB) or Intraarticular Facet Injection:
    • Targets the medial branch nerves that supply the facet joints, or directly targets the facet joints.
    • Used to diagnose and treat pain caused by facet arthropathy (arthritis or degeneration of the facet joints).
    • Offers temporary relief and helps confirm if the facet joints are the pain source.

Procedure Overview

  1. Before the Procedure:
    • Discuss your medical history, medications, and allergies with your doctor.
    • identification the level and area of the pain
    • Avoid blood thinners or other medications if instructed.
  2. During the Procedure:
    • You will lie on your stomach or side, depending on the injection site.
    • The area is cleaned and numbed with a local anesthetic.
    • Using fluoroscopy (X-ray guidance) or ultrasound, a needle is guided to the target area.
    • For steroid injections, a mixture of corticosteroids and anesthetic is delivered.
    • For medial branch blocks, a local anesthetic is injected near the medial branch nerves.
  3. After the Procedure:
    • You will be observed briefly for any immediate reactions.
    • Mild soreness at the injection site is common and usually resolves within 1–2 days.

Benefits of Steroid Injections and Medial Branch Blocks

  • Targeted pain relief and reduced inflammation.
  • Diagnostic confirmation of the pain source.
  • Improved mobility and function.
  • Non-surgical option to manage pain.

Expected Results

  • Epidural Steroid Injections: Pain relief typically begins within 1–3 days and may last weeks to months.
  • Medial Branch Blocks: Relief may be immediate and typically last 1-2 months. If successful (pain reduction > 50%), it can guide further treatment such as radiofrequency ablation (a longer-lasting procedure that disrupts pain signals).

Risks and Side Effects
These procedures are generally safe, but risks include:

  • Temporary soreness or increased pain at the injection site.
  • Headache, dizziness, or nausea.
  • Rare complications: infection, bleeding, or nerve damage.

Post-Procedure Care

  • Rest for the day of the procedure.
  • Avoid heavy lifting or strenuous activities for 24–48 hours.
  • Report any unusual symptoms such as fever, redness, or worsening pain.

When to Seek Medical Attention
Contact your doctor if you experience:

  • Persistent or worsening pain.
  • Fever, chills, or signs of infection.
  • New or worsening numbness, tingling, or weakness.

Frequently Asked Questions

  1. How do medial branch blocks confirm the source of pain?
    If pain relief occurs after the block, it indicates the facet joints are the likely pain source.
  2. How many injections or blocks will I need?
    For medial branch blocks, relief may guide further treatment with radiofrequency ablation, which provides longer-term relief. Steroid injections are generally limited to 3–4 times per year.
  3. Will these procedures cure my pain?
    These are pain management options and do not cure underlying conditions but can improve pain, quality of life, and mobility.

Contact Information
For more information or to schedule a consultation, please contact us

Disclaimer

This fact sheet is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment options.

The information provided here reflects general practices and may not apply to your individual health circumstances. Outcomes and risks may vary depending on your medical history, condition, and response to treatment.

If you experience any concerning symptoms or side effects following a procedure, contact your healthcare provider immediately or seek emergency medical attention.

This material is not intended to promote or endorse any specific treatment or procedure. Decisions about your healthcare should always be made in consultation with your physician, considering your unique health needs and goals.

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