A large number of these injections are used to treat patients with pain that stem from their spine. These include epidural steroid injections and selective nerve root blocks that target the inflammation associated with a pinched nerve. We also target other pain generators in the spine such as the facet joints, the sacroiliac joints and the discs. Sometimes patients can benefit from a series (usually 2-3) of epidural steroid injections which can give the best clinical outcome. This is done if the patient is in a significant amount of pain with a severely inflamed nerve. Multiple injections are necessary to wipe all the associated inflammation.
There are also special procedures which can be performed that do not utilize steroids and can eliminate your pain for an extended period of time such as a radio frequency ablation and spinal cord stimulators. Other injections are used to target pain stemming from the hip, knee, shoulder and ankle joints. These can involve the use of steroids, viscosupplements, platelet-rich-plasma and stem cells. Patients who cannot tolerate steroids for medical reasons can benefit from these alternative treatment options.
Most injections into the knee or a smaller joint, like that at the base of the thumb, are simple procedures that can be done in a doctor’s surgery. When performed by an experienced physician, the injection is only mildly uncomfortable.
First, the doctor cleans the skin in the area with an antiseptic. If the joint is puffy and filled with fluid, the doctor may insert a needle into the joint to withdraw the excess fluid and examine it. Removing the fluid rapidly relieves pain also because it reduces pressure in the joint and may speed-up healing. Next, the doctor uses a different needle to inject the corticosteroid into the joint.
Injecting a large joint, like the hip, is more complicated and may require imaging tests to help the doctor guide the needle into the joint. Experienced rheumatologists, orthopaedic surgeons, anaesthetists, and radiologists may inject the facet joints of the lower spine.