SPINE
A range of interventional procedures for pain can be useful in patients with chronic pain who have not achieved adequate relief with conservative treatments. The corticosteroid injected serves as a powerful anti-inflammatory to manage inflammation and improve pain. Below is a belief explanation of these different common procedures for spinal pain of the cervical, thoracic, lumbar and sacral location.
Epidural steroid injections (ESI) can help relieve pain caused by inflamed spinal nerves due to spinal stenosis or disc herniation. Epidural steroid injections can help treat back pain, neck pain, arm and leg pain and radicular extremity symptoms.
ESIs are done near the epidural space in the spine. This space represents the area between the spinal vertebrae and the membrane covering them, a structure known as the dura. When this corticosteroid is injected next to an inflamed area that pinches nerve tissue, it reduces the swelling and inflammation to relieve, not only local pain but also referred pain from the nerve impingement. Epidural steroid injections are commonly recommended when more conservative treatments have failed for such conditions as Lumbar spinal stenosis (a bony narrowing of the spinal canal), herniated lumbar discs and Degenerative disc disease (including bulging discs).
A transforaminal epidural steroid injection (TFESI) is a specific type of epidural steroid injection, distinguished by the method of accessing the epidural space. In a TFESI, the injection is delivered through the foramen, a small opening through which spinal nerve roots exit the spinal column. This approach allows the medication to be administered directly near the nerve root, which is often the source of pain due to compression or inflammation. Unlike a traditional epidural injection, which targets the entire epidural space, a TFESI specifically targets the area where the nerve exits the spine, often providing more focused and localized pain relief to the lower back and radicular extremity symptoms to that side of spine that the procedure is attempted. It can also be attempted as a bilateral procedure.
Joint injections of the Spinal facet joints and Sacroiliac joints can alleviate localized spinal pain focused on the joints that connect and articulate the vertebrae. The needle may penetrate the joint itself, or it may penetrate a medial branch nerve that routes nerve signals from a particular facet joint.
Joint injections are administered to relieve arthritic joint pain of the cervical, thoracic, lumbar facet joints and the sacroiliac joints.
