Back pain is something that most people will experience sometime in their lifetimes; in fact, it is estimated that 80% of Americans will experience such pain at some point in their lives.
There are of course a number of methods to alleviate such pain. Depending upon its severity and cause, solutions run the gamut from over-the-counter and prescribed pain medications to a host of surgeries; the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NINDS) identifies nine, including vertebroplasty and kyphoplasty for fractured vertebra; discectomy and microdiscectomy, wherein a herniated disc is removed through an incision in the back; and spinal laminectomy, wherein the lamina (or bony walls) of the vertebrae are removed.
To those I would add the fluoroscopic spinal injection, a minimally invasive procedure for those suffering from severe arm, leg, neck, or back pain. The procedure’s goals are to determine the exact cause and location of the patient’s pain, and to provide relief from that pain.
The injection itself is a mixture of local anesthetic and a steroid, such as cortisone. If the patient experiences immediate pain relief, that will be due to the local anesthetic and mean that the correct cause of the pain has been determined. The steroid is used to reduce inflammation and pain in the longer-term.
As for “fluoroscopic,” that means that a fluoroscope (or X-ray) is used to guide the needle into the exact location that your physician/surgeon believes is causing you pain. Fluoroscopic spinal injections are often used on patients suffering from spinal stenosis, back pain, herniated discs, degenerative discs, sciatica, and other conditions.
By providing relief that can last for several months, and by identifying precisely from where the pain is originating, your physician can help develop a regimen for further down the road – which, admittedly, could ultimately lead to surgery.
But the fluoroscopic spinal injection is an attractive and valuable option. It is a minimally invasive procedure that requires no sedation (although sedation is available), can be done in our office and usually takes 15-30 minutes. If the procedure is successful, it is considered reasonable to repeat it up to 3 times a year, based on the patient’s individual response and requirements.
If the treated region is indeed the cause of the patient’s pain, the patient may experience immediate pain relief, and longer-lasting pain relief 2-5 days after the injection.
Note that the procedure should not be performed on anyone who is pregnant, has an infection, or suffers from bleeding problems. For further information, discuss with your physician the possibilities that a fluoroscopic spinal injection may offer you.
Dr. David Spinner is Director of Pain Management at White Plains Hospital. For an appointment, call 914-849-1199.