FAQs on Disc Injection in Dallas & Fort Worth
Back pain may cause a person not to be able to participate in physical activities or daily life events. The doctor will often prescribe physical therapy, exercises, and medications to help someone relieve the pain associated with low back pain. In certain cases, the doctor will use spinal injections as a part of nonoperative treatment. These injections allow the doctor to diagnose the source of low back pain so it can be reduced or eliminated.
Disc injection procedure involves inserting a needle into the area or space of the spine for the purpose of inserting numbing medications. Local anesthetics will numb the nerves temporarily to prevent pain signals from traveling to the brain. Corticosteroids are injected to reduce local inflammation that affects and irritates nerve fibers.
There are several spinal structures that receive nerve supply. The structures of the spine and their nerves send pain signals to the brain. The most common pain-generating structures are the intervertebral discs (shock absorbers), nerve roots and dorsal root ganglia (nerve cells near nerve root), facet joints (those uniting back bones), sacroiliac joints (joints that unite the hip and tail bones), muscles, and spinal ligaments. The pain management specialist will inject a local anesthetic through a needle placed in or around the structure where the pain occurs. This only provides temporary relief, but when combined with lidocaine, the relief lasts longer
Types of Spinal Injection Procedures
Spinal injection procedures for the lumbar spine (low back) include epidural steroid injections, nerve blocks, facet joint blocks, sympathetic ganglion blocks, and sacroiliac joint injections. The doctor will use a colorless, iodine-based contrast and inject it with a special x-ray so the needle goes into correct position.
- Epidural injections – An epidural injection is where medication is placed into the fatty space that surrounds the spinal sac and nerve root to relieve back and leg pain. These injections are given to people with bulging disc material that is in the spinal canal irritating nerves (intervertebral disc herniation) or narrowing of the spinal canal spaces where nerves pass through (spinal stenosis).
- Facet joint injections – These injections go directly into facet or sacroiliac joints, done when the doctor suspects that one of these areas is the initial source of low back pain or associated hip, buttock, and/or leg pain. Many times, the doctor will inject a small amount of anesthetic to the nerves of the joints for diagnostic purposes.
- Lumbar sympathetic ganglion blocks – These injections are where a needle is placed along the front aspect of the spine and local anesthetics are injected on a collection of nerve cells called the ganglia so the doctor can determine the origin of limb pain. This is done for widespread limb pain, swelling, and skin hypersensitivity.
- Discography – This involves placement of needles into the center of the disc so an iodine-based contrast can be injected. This is done for low back pain and leg pain. Imaging tests, such as MRI and CT scans, will show any disc abnormalities. A discography is the only way a doctor can determine the reason for certain types of back pain. Also, a discography is used when the doctor is considering a spinal fusion, where two or more back bones are permanently joined together.
Reasons to get Disc Injections
When conventional medical interventions do not work, the patient is prescribed a spinal injection for chronic low back pain. These treatments include oral medications, physical therapy, exercises, mobilization, bracing, and exercises. People who are candidates have moderate to severe pain that interferes with regular daily activities and last longer than a few months. Generally, you cannot get a spinal injection if you:
- Have a local or systemic infection
- Have severe bleeding disorder or are on blood thinner medication
- Are pregnant
- Have congestive heart failure or uncontrolled diabetes
The number of spinal injections depend on the type of procedure done and whether that procedure gives you relief of pain. Diagnostic injections are usually performed twice, whereas therapeutic injections are repeated to offer long-term relief. Usually, it takes three to six injections each year for best effects, but you may still require back surgery. Spinal injections are a useful nonoperative therapy for leg and low back pain, but the decision to have these is based on the individual’s unique needs.
Cellular Disc Injections
Cellular disc injections are where a small amount of bone marrow aspirate is taken from the back of the pelvis. After the bone marrow is extracted, it is placed in a centrifuge to concentrate the stem cells and plasma, which contains growth factor. The doctor uses x-ray guidance to inject this solution into the precise location of injured or degenerated discs.
The tissues in the body age and grow. Bone marrow produces mesenchymal cells which are delivered by the blood to various areas of the body. These cells help with body repair and growth processes. Mesenchymal cells can transform themselves into other types of cells, and the ones that come from the bone marrow are a type of stem cell.
In the back, the disc are fibrous structures that lie between each spinal bone to cushion and permit mobility. These discs have very little blood flow, so they are easily irritated. It is hard for the body to deliver cells and healing substances to these discs so they can repair themselves. For patients with chronic low back pain related to degenerative disc problems, these discs will not heal if they do not receive blood. To stimulate the body’s repair process, a cellular disc injection procedure can be used.