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Injections

Common causes of pinched nerves include disk protrusions into the nerve space, arthritic facet joints with a narrowed spinal canal and bone spurs. Less often, scar tissue that has formed from a previous surgery can cause nerve impingement and pain.

Nerves exit the spinal cord through the epidural space. Physicians use this space to deliver medicine near the spinal nerves. The most-effective medicines include local numbing medicines and anti-inflammatory steroids, which help reduce swelling and inflammation that can lead to pinched nerves.

Nerve irritation can cause pain, tingling or numbness.

What is the epidural space?

The membrane that covers the spinal cord and nerve roots in your spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to your back and into your legs. Inflammation of these nerve roots may cause pain in these regions because of irritation from a damaged disk or from contact with the bony structure of the spine. The epidural space is normally filled with fat and blood vessels. Fluid, such as the lidocaine and cortisone that is injected, is free to flow up and down the spine and inside the epidural space to coat the nerves that run inside the spinal canal.

What is an epidural injection and why is it helpful?

An epidural injection places antiinflammatory medicine into the epidural space to decrease inflammation of the nerve roots to reduce pain. The epidural injection may help the injury heal by reducing inflammation. It may provide permanent relief or pain relief for several months while the cause of your pain is healing. Sometimes the injection may be used to control the symptoms so you can participate in physical therapy, become more active and better control the symptoms with a conservative program.

What are the neuro foramina?

The neuro foramina are openings in the vertebrae where nerves pass. The opening includes a hole through the bone and a gap between the vertebrae that is kept open partly by the disks.

What is a neuroforaminal injection, and why is it helpful?

A neuroforaminal injection places antiinflammatory medicine near the foramina to decrease inflammation of the nerve roots to reduce the pain in your back or legs. The injection may help the injury heal by reducing inflammation. It may provide permanent relief or pain relief for several months while the injury or cause of your pain is healing.

What is a disk-space injection, and why is it helpful?

Disk-space injection helps confirm that the disk(s) is a source of your pain. This procedure involves placing a needle into the disk and injecting a combination of medicines. The most-effective medicines include numbing and antiinflammatory medicines. Computed tomography (CT) and magnetic resonance imaging (MRI) show only anatomy and cannot identify your pain source. The disks often are abnormal on MRI or CT scans but are not the source of pain. Only disk-space injection can tell if the disk is the source of pain. A disk-space injection helps the surgeon plan the correct surgery. Disk-space injection is usually done if you think your pain is significant enough for you to consider surgery.

What is a lumbar-facet injection, and why is it helpful?

Facet-joint injections are commonly used to determine what is causing back pain. Facet-joint injections help your physician determine the cause of your back pain, but they may not provide long-term relief from the pain. These injections eliminate pain temporarily by filling the facet joint with an anesthetic medicine that numbs the facet joint, the ligaments and joint capsule around the facet joint.

By placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm the joint as a source of pain. The temporary relief of the numbing medicine also may better allow a chiropractor or physical therapist to treat that joint. In addition, time-release cortisone will help reduce any inflammation that you may have in your joint(s).

What is a sacroiliac-joint injection, and why is it helpful?

A sacroiliac-joint injection places numbing medicine into the joint. The amount of immediate relief will help confirm the joint as a source of pain. Tim-release cortisone also may be injected to help reduce inflammation in the joint.

The sacrum is at the lower end of the spine, just below the lumbar spine. The sacrum is a triangle-shaped bone formed by the fusion of several vertebrae. The sacroiliac joint sits between the sacrum and the iliac bone. You can see these joints from the outside as two small dimples on each side of the lower back at the belt line.