Injection Therapy
Injection therapy is a minimally invasive approach used to diagnose and treat many spine-related conditions. By targeting the source of pain with precision, these procedures can reduce inflammation, relieve nerve irritation, improve function, and, in many cases, help patients avoid or delay surgery.
The Spine Institute of Arizona offers a variety of image-guided injection therapies tailored to each patient's condition and treatment goals.
Injection Therapy Options
Epidural Steroid Injections
Cervical Epidural Steroid Injections
Facet Joint Injections
Selective Nerve Root Blocks
Trigger Point Injections
Radiofrequency Ablation
Epidural Injections
A lumbar epidural steroid injection (Lumbar ESI) is an injection of anti-inflammatory medicine-a steroid or corticosteroid- into the epidural space around the spinal nerves. The main goal is to manage chronic pain caused by irritation and inflammation of the spinal nerve roots in your low back, which can be due to certain conditions or injuries. This type of chronic pain is called lumbar radiculopathy, and it can radiate down from your back to your hips, legs and or feet.
Cervical Epidural injections
A cervical epidural steroid injection (cervical ESI) is an injection of anti-inflammatory medicine, a steroid or a corticosteroid, into the epidural space around the spinal nerves. The main goal is to manage pain caused by irritation and inflammation of the cervical nerve roots. Also known as cervical radiculopathy, this can present as neck pain, arm pain, or weakness.
Facet Injections
Medication is injected directly into the joint, and is also called an intra-articular facet joint. These injections can also be used to diagnose the source of pain, as a positive response would indicate that the facet joint is the source of the pain.
Select Nerve Root Blocks (SNRB)
These are used both to diagnose and treat pain caused by irritation or inflammation caused by a specific spinal nerve. The procedure is used when there are pain symptoms radiating such as sciatica, arm pain or numbness to pinpoint the nerve root responsible (e.g. mapping the pain to L4 versus L5). These steroid injections can also reduce inflammation and pain along the irritated nerve pathway. SNRB injections differ from epidurals in that they are given to specific nerve roots rather than the entire epidural space. The pain relief may start within a few days, and diagnostic information is usually evident within 24 hours.
Trigger Point Injections
(TPIs) are a treatment that involves injecting a local anesthetic or other substance into a muscle trigger point to relieve pain and relax muscles. They are thought to temporarily relax the muscle and, which can improve blood flow, and break the pain cycle. They are used to treat myofascial pain, which can include chronic or episodic headaches, back pain, and temporomandibular joint pain. TPIs can be combined with corticosteroid or numbing agents such as lidocaine, or with no substance (dry needling), and they can be administered not more frequently than every three months.
Radiofrequency Ablation
RFA is for the long-term relief of the chronic neck (typically C3-C7), thoracic (typically T5-6), lumbar (typically L3-L5), that originates from facet joints-the small bones of the spine. These joints can become painful from arthritis, injury, or degeneration. Before performing this procedure, a diagnostic medial branch block is done to confirm the pain source. The procedure uses a fluoroscopic guided needle positioned near the small sensory nerves (medial branch nerves) that carry the pain signals from the affected facet joints. Numbing agent is used, and then a controlled radiofrequency current is applied through the needle tip, gently heating and deactivating those pain-transmitting nerves.The pain relief typically lasts 6-18 months, it improves mobility and function, reduces the need for pain medications and only requires 1-2 days of downtime.This procedure does not impact muscle strength or spinal cord function.
Read More: Facet joint syndrome: from diagnosis to interventional management - PMC
PATIENT EDUCATIONLearn More About Spine Injections
Hear from injection specialist Dr. Rowley as he explains common spine injections, answers frequently asked questions, and helps you better understand your treatment options.
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