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There are several different types of injections. They can be classified as injections for back (and pelvic pain) or for leg pain (sciatica).

Injections for back (and pelvic) pain include facet joint injections, sacroiliac injections and coccyx injections.

Injections for leg pain coming from the nerves in the back are nerve root block injections and caudal epidurals.

What is in the injection?

A mix of local anesthetic and steroids is injected into the specific area. This aims to reduce swelling, inflammation and pain.

Are there any risks?

There are very small and very infrequent risks of injections. These may include temporary discomfort, an allergic reaction to the medication, infection and bleeding, temporary numbness in legs or injury to the nerves.

For back pain

1) Facet joint injection
These injections are used to treat low back pain (or pain going down to the buttocks) that is coming from these joints at the back of the spine. Facet joints are about the size of a broad bean and one or more of these joints are chosen to be injected. The procedure is usually done under local anesthetic and x-ray guidance.

2) Sacroiliac injection
These injections are used to treat pain coming from sacroiliac joints, which are at the back of the pelvis but can also give rise to low back pain. The injections go directly into one or both sides into the long joints. The procedure is usually done under local anesthetic and x-ray guidance.

3) Coccyx injection
The coccyx is known as the tailbone and it can also be a source of pain. The procedure to treat this involves injecting the painkillers and steroids around the tailbone. It may also involve manual manipulation of the coccyx. The procedure is usually done under local anesthetic or under general anesthetic if the coccyx is manipulated.

For leg pain

1) Caudal epidural
Epidurals are predominantly used to relieve pain in the legs coming from a pinched nerve in the low back or due to spinal stenosis. The injection is inserted at the very bottom of the spine inside the spinal column acting directly near the affected area. The procedure is usually done under local anesthetic and x-ray guidance.

2) Nerve root block
These injections are to treat pain coming from nerves that can be irritated (sciatica) or compressed in the low back (spinal stenosis). Symptoms include mainly pain going down to the legs. Depending on the location of symptoms and findings on an MRI scan, the area around the specific nerve is injected. The procedure is usually done under local anesthetic and x-ray guidance.

What to expect?

The effectiveness of injections varies from person to person. Some people feel immediate pain relief that can last several months or years. For others, there is limited benefit following the procedure. No treatment is guaranteed to work for all people however it is always important to start or continue with a regular exercise routine to strengthen your body, improve your fitness and move better. Your physiotherapist will be able to advise you regarding the most appropriate exercises for you. The most effective long-term improvement is likely to be achieved by including exercise and education along with injection treatments.

Last tips

  • Every person gets a different level of relief so do not panic if it isn’t as you expected
  • Ongoing pain does not always mean that there is damage
  • Pain is a subjective feeling influenced by many other factors (your psychological state, your environment, genetics, relationships, family dynamics, stress, work satisfaction and more)
  • The most recommended treatment is a healthy lifestyle including enough exercise, relaxation, healthy diet and staying positive
The Patient Line website offers information for patients with spinal conditions:
Sciatica, back pain, spinal stenosis, disc herniation, scoliosis and many other spine conditions explained in a clear reliable, and trustworthy way. Not for profit EUROSPINE experts are here to help patients and their families understand what may be worrying them.

EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.

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page last updated on 21.08.2019