Role of injection therapies is discussed in this section

Injections are often used as diagnostic tool and are considered to be "successful" even if 50-75% pain relief is obtained. Local anasthesia is used for all injections after which a quiet day is recommended.

Nerve Root Blocks:  Xrays are used to insert a needle near the nerve that is being irritated. A mixture of local anasthetic and steroid is injected and usually gives good relief of leg pain.  The effect may last more than 6-12 weeks but the injection may have to be repeated if leg pain returns.

Facet injections: - May be used for diagnosis but have not been proven to be effective for treatment of back pain.

Radiofrequency Neurotomy: This technique uses an electric current that is passed through a special needle to generate heat which numbs the nerves supplying facet joints in the back reducing back pain. Careful selection of patients is required to determine those who will benefit form this technique.

Epidural injections: Usually provide short and long term pain relief and may obviate the need for surgery. A mixture of saline and steroid is injected within the epidural space present around the nerves. A Lumbar Epidural is given in the middle of the back and is usually administered by an anaesthetist using local anaesthesia.  A Caudal Epidural is given at the tail end of the spine. I use xrays to ensure correct placement of the injection.

Sacroiliac injections: A mixture of local anaesthetic and steroid is injected into the sacroiliac joint which is a deep joint in the back. Xrays are usually used to confirm correct placement of the needle.

Hip injection: Is used to ascertain that the pain is coming from the hip joint. Xrays are used to inject a mixture of local anaesthetic and steroid into the hip joint.

Discography: is used to assess pain arising from the disc and is done using local anasthesia with sedation. This means that you will be slightly sleeply but not completely "knocked out". I usually ask you to tell me how the discomfort that you feel  during the injection compares with the pain that you usually get.