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Do I Need a Spine Injection?

Spine Injections

“So, doc, do I need a spine injection?“ This is a question I hear multiple times a day. You would think that the answer is very simple but in my opinion it really is not. There are many factors that come in to play as to when to get a spine injection.

First you need to understand the role of spine injections. Spine injections can be both diagnostic and therapeutic. What that means is that a diagnostic injection will help diagnose and determine the source of a patient’s pain. Therapeutic injections usually involve injecting steroids or other solutions to provide relief of pain.

At Synergy Rehabilitation & Wellness Center, in Scottsdale, AZ we do spine injections can be used to rule in and rule out the cause of pain. Most diagnostic injections involve injecting an anesthetic or medicine to numb or “block” the area. The anesthetic has a temporary effect to block pain. In doing so it helps determine if the pain is coming from a particular source.

What that means is if I place an anesthetic over a certain area or nerve and you get temporary relief of your pain, that tells the patient and me that the pain is coming from that area.

If, however when I inject an anesthetic and the patient reports no relief to the pain then that nerve or area is not the source of your pain. This is particularly important when trying to determine which spine level is causing the pain. This is particularly helpful when working with surgeons to localize the source of the pain.

Patient usually have multiple levels of degeneration or stenosis in their spine. That does not mean that every level requires surgery. Therefore, a selective nerve block can help pinpoint which level is causing the pain and therefore allows the surgeon to perform surgery only at the necessary level.

So why would you get a spine injection? Spine injections are mainly performed to help alleviate pain. Spine or back pain could be related to a disc herniation, degenerative disc disease, spinal stenosis, or facet arthritis most commonly. However, just because a patient has findings on his or her MRI does not mean that he or she needs to get a spine injection.

Degenerative changes on an MRI in asymptotic people can be found in a person as early as their 20s. Obviously if a patient is not in any pain a spine injection would not be performed as we are treating the person and not the MRI. Therefore, if a patient’s pain correlates with the MRI findings, they are a candidate for a spine injection. But just because someone is a candidate for a spine injection does not mean they need to get a spine injection.

At Synergy Rehab & Wellness Center, in Scottsdale, AZ we take into account the intensity of the pain, the duration of the pain, and any functional deficits that could be improved with a spine injection. Whether a patient has tried and failed conservative measures is another step in determining if a spine injection is necessary or needed. Many patients will improve with anti-inflammatories and rest. Other patients will also improve with physical therapy. Ideally, we will try these measures prior to proceeding with a spine injection.

There are risks involved with any spine injection thus the decision to proceed with a spine injection should not be taken lightly. At the same time, spine injections are performed when the pain is severe and the patient cannot participate in conservative measures.

While many people improve with physical therapy some patients are in such severe pain that they cannot tolerate physical therapy. Therefore, a spine injection will be performed to help alleviate the severe pain and allow them to complete their rehabilitation. At the same time if the patient has been participating in physical therapy but are at a plateau, a spine injection may be performed as a way to help them participate even more with the physical therapy.

Again, the intent of a spine injection is to help diagnostically or to relieve pain. As simple as the spine injections appear to be, they are still not to be taken lightly. There are many factors to consider when proceeding with a spine injection. We at Synergy Rehabilitation & Wellness Center, in Scottsdale, AZ are able to take into consideration all the factors necessary to ensure proper treatment is performed.

Author
Anthony Lee, MD Anthony Lee, MD Dr. Lee is a board certified, fellowship trained Physical Medicine and Rehabilitation physician that specializes in non-operative treatments of musculoskeletal injuries. He holds board certifications in Physical Medicine and Rehabilitation as well as the subspecialty of Pain Medicine. His philosophy is simple – finding the best non-operative & personalized treatment plan for his patients to improve their quality of life, allowing them to “Live In Motion!” Dr. Lee graduated with a BA in Microbiology from Dartmouth College. After Dartmouth, he returned home to Georgia where he graduated with a Masters of Science degree in Microbiology from Georgia State University. He then received his Doctorate of Medicine from Mercer University School of Medicine. He completed his residency training in Physical Medicine and Rehabilitation at the Hospital of the University of PA where he served as Chief Resident for two years. He relocated in 2004 to AZ where he completed a Sports Medicine & Interventional Spine program.

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