Injections – Injections for the Lower Back

Injections or shots in the lumbar spine (lower back) aim exclusively at relieving lower back pain or pain in the lower limbs, i.e., sciatica.
The most common types of injections are three:

A. Simple epidural injections

B. Transforaminal epidural injections (targeted at the root that causes the pain)

C. Facet joint injections (Facet), which are performed for lower back pain.

All injections must be performed under fluoroscopic guidance – and not on the examination bed – in order to accurately reach their target. They are performed via posterior approach between the bones of the spine, specifically above the dura mater of the sac containing the nerves. Respectively, Facet injections are performed inside the small joints at the back of the spine when they are inflamed and cause pain.
They are selected in cases of inflammatory swelling of nerve roots compressed by herniated discs, mainly of the lumbar spine, and focus on the pain area. The substance injected infiltrates the neural elements of the area and the hernia itself. A basic advantage is that this substance does not cause complications.
Pain relief is almost certain, since the steroids reduce the inflammation of the nerve, which “deflates” and is now less compressed. Thus, the patient will regain lost mobility, and if there is a long-term response with simultaneous absorption of the disc, surgical intervention may be avoided.
In the case of Facet injections, relief comes from combating the inflammation of the joint itself. In resistant cases, the method of ablation of the sensory branch that innervates these small joints is applied – a type of denervation. Ablation is again performed with needles whose tips are either heated or cooled in order to stop the transmission of pain signals to the brain. Thus, the patient is relieved for a long period (up to 2 years).

Patient Preparation for Injection

The patient must be fasting for several hours before the injection to avoid any episode of nausea. Anticoagulants will be discontinued several days before the injections.
You may return home immediately after the procedure, but driving is prohibited.
The injections are performed in a specialized clinical area with imaging guidance where the surgeon sees the path of the needle on the screen.