Trigger point injections. Sometimes, putting pressure on a certain spot in the back
(called a trigger point) can cause pain at that spot or extending to another
area of the body, such as the hip or leg. To try to relieve pain, a local anesthetic, either alone or combined with a corticosteroid, is injected into the area of the
back that triggers pain (trigger point injection).
Facet joint injections. A local anesthetic or corticosteroid is injected into a facet joint, which is one of the points where one vertebra connects to another.
Epidural injections. A corticosteroid is injected into the spinal canal where it bathes the sheath that surrounds the spinal cord and nerve roots.
Local anesthesia is believed to break the
cycle of pain that can cause you to become less physically active. Muscles that
are not being exercised are more easily injured. Then the irritated and injured
muscles can cause more pain and spasm and can disrupt sleep. This pain, spasm,
and fatigue, in turn, can lead to less and less activity.
reduce inflammation. So a corticosteroid injected into the spinal canal can
help relieve pressure on nerves and nerve roots.
Why It Is Used
Injections may be tried if you
have symptoms of nerve root compression or facet inflammation and you do not
respond to nonsurgical therapy after 6 weeks.
How Well It Works
Research has not
shown that local injections are effective in controlling low
back pain that does not spread down the leg.footnote 1
All medicines have side effects. But many people don’t feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Usually the benefits of the medicine are more important than any minor side effects.
Side effects may go away after you take the medicine for a while.
If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
Pain and swelling around the injection site that lasts more than 2 days.
One common side effect of this medicine is pain and swelling the first day or two after the
injection. It may help to apply ice at home for 15 to 20 minutes.
Trigger point injections
Possible side effects
include nerve or other tissue damage, infection, or excessive bleeding.
Facet joint injections
Possible side effects
include pain at the injection site, infection, excessive bleeding, nerve
damage, or spinal cord inflammation.
Epidural steroid injections
effects include headache, fever, or infection. Serious side effects are rare. But they can include stroke, paralysis, or loss of vision.
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
These injections can be painful.
Most orthopedists and rheumatologists advise against repeated
injections of corticosteroids directly into joints, including joints of the
spine, because degeneration or damage to joint cartilage may occur.
Nobody likes needles. But experienced doctors can usually do the injection in under 30 seconds. It does hurt, but it’s quick.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don’t take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
Dixit R, et al. (2013). Low back pain. In GS Firestein et al., eds., Kelley’s Textbook of Rheumatology, 9th ed., vol. 1, pp. 665-682. Philadelphia: Saunders.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine E. Gregory Thompson, MD – Internal Medicine Adam Husney, MD – Family Medicine Kathleen Romito, MD – Family Medicine Specialist Medical ReviewerNancy Greenwald, MD – Physical Medicine and Rehabilitation