What is a steroid injection, why is it used for spinal and sciatic pain and do I need one?

By Bowskill Clinic on Saturday, May 12th, 2018

A steroid injection is used by spinal surgeons and pain management consultants as a way of getting corticosteroids closer to the area of inflammation at the disc, facets  or nerve roots. This can be targeted to different areas if the spine by using a moving X-ray or fluoroscope and a dye called omnopaque which when mixed with the steroid and local anaesthetic shows the doctor exactly where the infiltrate is going.  The steroid can be injected into the facet joints of spine, towards the dorsal root ganglion through the lateral recess or into the epidural space depending on what the pain generators are considered to be.

This usually used when conservative measured like physiotherapy, osteopathy and exercise therapy are not working or are difficult for the patient to do because of limitation by pain. Under those circumstances this procedure can be very useful and provides a window of 3-4 months when rehabilitation can be completed with lower risk of irritation.

The procedures can be done under local anaesthetic or sedation or in some circumstances general anaesthetic. If done under sedation the patient will to be more still during the procedure but not able to provide any feed back about what they are feeling in terms of symptoms. If they are just under local then they are able to tell the doctor any sensations of pain or if the pressure of the inflow of the infiltrate is causing their symptoms . This can sometimes be a good guide for whether the injection has been placed in the right place and provides valuable feedback to the doctor completing the procedure.

The procedure is done as an outpatient and you are usually allowed to return home with the accompaniment of a friend of family member 60-90 minutes after the procedure. Daily activities and exercise should be limited for the first three to four days, and it is then possible to begin a graded return to life as normal. Often times there is an accumulating benefit over the first two to three weeks and yon can expect a little tenderness after the local anaesthetic from the procedure has worn off but this usually doesn’t last long.

There are some risks with injections into the spine and these include infection as well as needle stick injury.  It is important when choosing a doctor for this procedure that you find someone who comes highly recommended and specialises in spinal injections.

If you would like a recommendation for one of the specialists that we use for this procedure please feel free to email [email protected]

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