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Click on an icon to view.When medications and other non-surgical treatments fail to relieve chronic back pain, doctors may recommend injections as part of back pain treatment for pain relief. Types of injections can include:
- Nerve root blocks
- Facet joint injections
- Trigger point injections
- Prolotherapy.
Nerve Root Blocks
If a nerve is inflamed or compressed as it passes from the spinal column between the vertebrae, an injection called a nerve root block may be used to help ease the resulting back and leg pain. Nerve root block injections contain a steroid medication and/or anesthetic, and the injection is administered to the affected part of the nerve. Whether the procedure helps or not will depend on finding and injecting precisely the right nerve.
Facet Joint Injections
The facet joints are those where the vertebrae connect to one another, keeping the spine aligned. Although arthritis in the facet joints themselves is rarely the source of back pain, the injection of anesthetics or steroid medications into facet joints is sometimes tried as a way to relieve pain. The effectiveness of these injections is questionable, and one study has suggested that this treatment is overused and ineffective.
Trigger Point Injections
In this procedure, an anesthetic (or a steroid medication) is injected into specific areas in the back that are painful when the doctor applies pressure to them. Although trigger point injections are commonly used, researchers have found that injecting anesthetics and/or steroids into trigger points provides no more relief than "dry needling," or inserting a needle and not injecting a medication.
Prolotherapy
Prolotherapy is one of most talked-about procedures for back pain. Prolotherapy is a treatment in which a practitioner injects a sugar solution or other irritating substance into trigger points along the periosteum (the tough, fibrous tissue covering the bones) to trigger an inflammatory response that promotes the growth of dense, fibrous tissue. The theory behind prolotherapy is that tissue growth strengthens the attachment of tendons and ligaments whose loosening has contributed to back pain. However, studies have not verified the effectiveness of prolotherapy, and only chiropractors and physicians primarily use this procedure.
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD