General spinal injection information

Spinal injections have been performed for many decades, and are generally considered as a very safe and effective treatment for pain originating from the spine.  Serious complications are rare, but could include allergic reaction, bleeding, infection, and nerve/spinal cord damage. However, when performed by an experienced and trained physician, the risk of a serious complication is minimized.  Every precaution is taken against these occurrences by the provider, but in accord, it is also very important that you disclose your complete medical history to the physician.  Overall, the injections are very well tolerated and most patients do well.  Although not all injections are 100% successful, often times they can provide you with improvement in pain and function that last several months or longer. If you experience significant benefit, the injections can be safely repeated periodically to maintain the improvements. Injections are also commonly coupled with other treatments (medications, physical therapy, etc.) in an attempt to either maximize the benefit or prolong the effects.

Prior to your injection, the procedure along with the benefits and risks will be discussed thoroughly with you during an office visit. Dr. Garala will discuss with you the type of spinal injection that is recommended as there are various potential spinal pain generators.  Even though the most common injection is an epidural steroid injection, there are various types of injections that can potentially help you.  If steroid is used, the goal of the injection is to place the medication as close to the potential pain source as possible for the steroid to have its therapeutic effect. 

The procedure length varies depending on the type of procedure performed, but it is done in an outpatient setting.  You walk into the procedure and you walk out of the procedure the same day.  Most procedures take 15 minutes.  A specific protocol is followed to ensure your safety.  Your medical history and type of procedure will be reviewed with you.  Please confirm any allergies you have, specifically to latex gloves, iodine, anesthetics (i.e. lidocaine), or steroids. 

You will be brought back to the fluoroscopy (X-ray) suite where you lay on a special procedural “bed”.  The site of the spinal injection will be cleansed and a local anesthetic is used to diminish the the discomfort associated with the injection.  In a sterile environment and under fluoroscopic guidance, the physician directs a spinal needle to the designated area in a careful, deliberate fashion.  Contrast dye is typically used to confirm proper needle placement before medication/treatment is administered.  On rare occasion, if the contrast dye pattern is not optimal (due to your anatomy), the injection may be terminated because it indicates the medication that is subsequently injected won’t get to the targeted area.  After the procedure, the needle is removed, your injection site is cleansed again and a bandage is placed.  After a period of post-injection monitoring to ensure you do not have any immediate post-procedure side effects/complications, you are discharged home.