Spinal injections

A steroid injection provided to give pain relief which involves an injection with a mix of local anaesthetic and steroids into an area near your spinal cord.  

During a caudal epidural, an anti-inflammatory medicine, such as hydrocortisone, is injected round the areas of inflammation in the spinal canal, directly into the epidural space in the spine. This injection is used when nerves in the lower back are inflamed due to irritation from either spinal stenosis (a degenerative narrowing of the spinal canal) or a spinal disc prolapse.

You'll usually be given a local anaesthetic first to number the area. Your consultant will use the latest scanning equipment to ensure the injection is guided to the correct spot. 

It can give you very effective relief during periods of acute pain as part of a comprehensive programme which includes stretching and strengthening exercises.

The dorsal root ganglion is a bundle of sensory nerve cells that send impulses to your spinal cord. If your spinal nerves are irritated, an injection can block painful impulses.

A selective nerve root block injection is used if you suffer from chronic back pain to offer relief by slowing or blocking painful nerve impulses. Treatment is done under local anaesthetic, meaning you’ll be awake but shouldn’t feel pain during the procedure.  

You'll be asked to lie on your stomach while your consultant inserts a special needle into your spine and carefully guides it towards the dorsal root ganglion. A small amount of contrast dye may be injected first. This will help them to see the exact position of the needle using an X-ray instrument called a fluoroscope.

Once the needle is in the correct position, a solution of a steroid, sometimes along with more local anaesthetic, will be injected to relieve the pain. As well as treating pain, a dorsal root ganglion block can be used to help pinpoint the area and the cause of your back pain.

Facet joints are thumbnail-sized pairs of joints in the neck, mid and lower back (the cervical, thoracic, or lumbar regions respectively). They connect the bones of your spinal column which gives you the stability and flexibility to move and rotate. A time-release steroid injection is used to locate which joints are causing pain and help reduce inflammation.

You will be asked to lie on your front. Your consultant will use the type of X-ray called a fluoroscopy to get real-time moving internal images of your spine on a screen. They will use it to locate which facet joint they want to inject. 

Your consultant will sterilise the skin on your back and inject a local anaesthetic. They will then use another needle to slowly inject a steroid solution into the affected facet joint. 

A sacral nerve root injection can block painful impulses sent from irritated nerves at the base of your spine (sacrum). The sacral nerve is part of the sacral plexus, a network of nerve fibres that supply the skin and muscles of the pelvis and lower limb. The network is located on the surface of the posterior pelvic wall and the anterior to the piriformis muscle. If you have persistent back, hip or limb pain, your consultant may recommend this type of spinal injection to help manage the pain or pinpoint its source.

You'll be asked to lie on your stomach. Your consultant will use an X-ray along with a nerve stimulator to help position the needle in the right location. Then a steroid solution, sometimes along with more local anaesthetic, is injected to reduce inflammation and numb the nerves.

A spinal injection, such as a sacral nerve block, can reduce inflammation and numb painful nerve signals, such as tingling, helping to manage spinal pain and associated pain radiating into your limbs.