Spinal Injections

If Spinal Injections for your neck or lower back have been recommended to you, please take the time to learn more about them before you make a decision. These injections can help alleviate pain in the neck, shoulders, back and legs for certain conditions. The decision to have an injection is usually made after conservative treatment options (activity modification, medications, and physical therapy) have failed. Any radiology results you have (MRI, CT Scans) will also be considered before injections are recommended.

  • Lumbar and Cervical Epidural Injections
  • Lumbar and Cervical Facet Injections
  • Trigger Point injection
  • Prolotherapy
  • PRP (Platelet Rich Plasma)

LUMBAR and CERVICAL EPIDURAL SPINAL INJECTIONS (ESI’s)

IF YOU TAKE ANY OF THE FOLLOWING MEDICATIONS, PLEASE DISCUSS DISCONTINUATION OF THE FOLLOWING MEDICATIONS OR VITAMINS 5 (FIVE) DAYS PRIOR TO YOUR INJECTION:

Anti-inflammatory medications, blood thinners, fish oil and all products that contain aspirin / aspirin compound.

If you have any doubts about your medications, please notify our staff before proceeding with injection.

You will be placed on your stomach for the procedure. Using fluoroscopy (live x-ray), a corticosteroid (Dexamethasone) is injected around the affected nerve into your neck or low back at a particular level (location as determined by your symptoms). This medication is used to reduce the inflammation around the nerves thereby reducing your pain. It is most often done for radicular or “nerve pain” in the extremities.

If a short acting anesthetic agent is used (lidocaine) in the lumbar area, this is also diagnostic as the pain should be immediately diminished for an hour or so after injection.

Risks of Spinal Injections

As with any surgical procedure or injection, certain risks must be considered. Injury to nerve root(s) resulting in paralysis, excessive bleeding, weakness or infection are possible risks of this procedure.

Although such complications are rare, you should feel free to discuss the question of risk with your doctor.

LUMBAR AND CERVICAL FACET INJECTIONS

IF YOU TAKE ANY OF THE FOLLOWING MEDICATIONS, PLEASE DISCUSS DISCONTINUATION OF THE FOLLOWING MEDICATIONS OR VITAMINS 5 (FIVE) DAYS PRIOR TO YOUR INJECTION:

Anti-inflammatory medications, blood thinners, fish oil and all products that contain aspirin / aspirin compound.

If you have any doubts about your medications, please notify our staff before proceeding with injection.

You will be placed on your stomach for the procedure. Using fluoroscopy (live x-ray), a corticosteroid (dexamethasone) is injected around the affected level into your neck or low back (location as determined by your symptoms). This medication is used to reduce the inflammation around the bones in the spine, improving their movement, thereby reducing your pain. It is most often done for neck and back pain that worsens with lack of activity.

If a short acting anesthetic agent is used (lidocaine), this can also be diagnostic as the pain should be immediately diminished for an hour or so after injection.

Risks of Spinal Injections

As with any surgical procedure or injection, certain risks must be considered. Injury to nerve root(s) resulting in paralysis, excessive bleeding, weakness or infection are possible risks of this procedure.

Although such complications are rare, you should feel free to discuss the question of risk with your doctor.

AFTER THE SPINAL INJECTIONS

  • It may take a few days before you begin to feel better after your spinal injections.
  • It is not uncommon to have discomfort over the site where the spinal injections were given. We recommend the use of an ice pack over the area for 15 – 20 minutes at a time.
  • There is the chance that you may experience some flushing or palpitations following the spinal injections. Diabetics may notice an elevation of blood sugar (glucose) levels. This tends to be a transient effect. These are not side effects or allergic reactions, but rather a normal action of the medication.
  • While everyone’s pain levels and tolerances differ, the amount of relief you get from the spinal injections depends on your particular symptoms and condition. In some cases, multiple spinal injections may be required. You will get the maximal benefit of the spinal injection within the first 7 days.
  • You should be able to return to your usual activities 24 hours post injection.

We encourage you to contact any member of the clinical staff at ShimSpine for any questions or concerns.

Trigger point injections

  • Trigger points are focal areas of muscle spasm often located in the upper back and shoulder areas or, less commonly, in the low back area.
  • A trigger point injection involves the injection of medication directly into the trigger point (nodule type area that spreads the pain when palpated). The injection may be an anesthetic such as Lidocaine or Marcaine, a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine.

The trigger point injection is performed in the office, usually with the patient either lying on the exam table on the stomach or sitting on the exam table. The trigger point is located by manual palpation and marked. The injection site is then cleaned with alcohol or Betadine. Frequently, a numbing spray such as ethyl chloride is used to anesthetize the skin and make the actual injection less painful. The needle is then inserted into the trigger point and the medication is injected. There may be several areas injected at the same time.

Post Trigger Point Injections

Ice for 15-20 minutes at a time can be used post injection

Anti-inflammatories or Tylenol can be used for any increase in pain

Remove band aids the next day

Check sugar more frequently if you are a diabetic

You can return to previous activities the next day

Prolotherapy / Platelet Rich Plasma (PRP)

Regenerative Medicine is a branch of medicine that is changing how we treat certain medical conditions. Traditional medical therapies have focused on the use of medications and other treatments to alleviate pain and disability. With regenerative medicine, the focus is on using the body’s own abilities to heal, repair, and restore itself. There are different components to this including cellular therapies, tissue manipulation and engineering, and the development of new biomaterials. Within our practice, we offer Regenerative Injection Therapies including Prolotherapy and Platelet Rich Plasma (PRP).

Prolotherapy has been around for many years. It involves injecting an “irritant” into an injured or painful joint or area of soft tissue (tendon or ligaments). The theory behind this is that the irritant will promote an inflammatory response leading the body to send a host of healing mediators to the area to reduce the inflammation and heal the affected area.

The use Platelet Rich Plasma (PRP) was originally developed in the late 1970’s for use on a limited basis. Now, the use of PRP has grown tremendously in the last decade. With PRP, a patient’s own blood is drawn and spun in a centrifuge to separate the components. The plasma is then combined with a special activator and is injected into a painful joint or area of soft tissue. The injected PRP is believed to draw new reparative cells into the affected area to promote healing and restoration.

After Prolotherapy / PRP Injections

Post injection with Regenerative therapy is the opposite of other injections. The goal is to increase the inflammatory process, instead of reducing it.

You will be asked to avoid anti-inflammatories for 4 weeks after the injection.

Avoid ice therapy.

Tylenol can be taken for acute pain.

We will ask you to decrease activity involving the area injected.

We encourage you call the clinical staff at ShimSpine with any questions or concerns you may have.