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Disc Injections

What is a Disc Injection? 

A disc injection is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves. A disc injection may be performed to relieve pain caused by spinal stenosis, spondylolysis, or disc herniation. Through the epidural space, medicine is administered to the spinal nerve through the epidural space, the area between the protective covering of the spinal nerves and bony vertebrae. Pain relief may last for several days or even years. The goal is to reduce pain so that you may resume normal activities and a physical therapy program.

Corticosteroids, platelet rich plasma, and stem cell injections can be effective when delivered directly into the painful area.While the injection does not make a herniated disc smaller; it only works on the spinal nerves by flushing away the proteins that cause swelling. The pain relief can last from days to years, allowing your spinal condition to improve with physical therapy and an exercise program.

Who is a Candidate for Disc Injection?

Patients with pain in the neck, arm, low back, or leg (sciatica) may benefit from a disc injection. Specifically, those with the following conditions:

  • disc injectionsSpinal stenosis: A narrowing of the spinal canal and nerve root canal can cause back and leg pain, especially when walking.
  • Spondylolysis: A weakness or fracture between the upper and lower facets of a vertebra. If the vertebra slips forward (spondylolisthesis), it can compress the nerve roots causing pain.
  • Herniated disc: The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall (annulus). Irritation, pain, and swelling occur when this material squeezes out and comes in contact with a spinal nerve.
  • Degenerative disc: A breakdown or aging of the intervertebral disc causing collapse of the disc space, tears in the annulus, and growth of bone spurs.
  • Sciatica: Pain that courses along the sciatic nerve in the buttocks and down the legs. It is usually caused by compression of the 5th lumbar or 1st sacral spinal nerve.

Disc injections have proven helpful for some patients in the treatment of the above painful inflammatory conditions. Disc injections can also help determine whether surgery might be beneficial for pain associated with a herniated disc. When symptoms interfere with rehabilitative exercises, epidurals can ease the pain enough so that patients can continue their physical therapy.

Who Should NOT Have a Disc Injection?

Disc injections should NOT be performed on people who have an infection or have bleeding problems. The injection may slightly elevate the blood sugar levels in patients with diabetes. It may also temporarily elevate blood pressure and eye pressure for patients with glaucoma. You should discuss this with your physician.

If you think you may be pregnant or are trying to get pregnant, please tell the doctor. Fluoroscopy x- rays used during the procedure may be harmful to the baby. 

Who Will Performs the Procedure?

Dr. Mohemani will perform the disc procedure. Before treatment, Dr. Mohemani will review a patient’s medical history and previous imaging studies before planning the best approach for injections. Feel free to ask Dr. Mohemani any questions you may have at this appointment. 

The procedure is usually performed in an outpatient special procedure suite that has access to fluoroscopy. Make arrangements to have someone drive you to and from the office or outpatient center the day of the injection.

What Happens During the Treatment?

Before time of the procedure, you will be asked to sign consent forms, list medications you are presently taking, and if you have any allergies to medication. The procedure may last 15-45 minutes, followed by a recovery period.

The goal is to inject the medication as close to the pain site as possible, using either transforaminal or interlaminar injection. The right type of injection depends on your condition and which procedure will likely produce the best results and the least discomfort or side effects.

  • Step 1: prepare the patient

The patient lies face down on an x-ray table. Local anesthetic is used to numb the treatment area. The patient experiences minimal discomfort throughout the procedure. The patient remains awake and aware during the procedure to provide feedback to the physician. A low dose sedative,  is usually the only medication given for this procedure.

  • Step 2: insert the needle Disc Injection

With the aid of a fluoroscope (a special X-ray), the doctor directs a hollow needle through the skin and between the bony vertebrae into the epidural space. Fluoroscopy allows the doctor to watch the needle in real-time on the fluoroscope monitor, ensuring that the steroid medication is delivered as close to the inflamed nerve root as possible. Some discomfort occurs but patients typically feel more pressure than pain.

There are two ways to deliver epidural steroid injections: transforaminal or interlaminar. The best method depends on the location and source of pain.

  • Transforaminal ESI (from the side). The needle is placed to the side of the vertebra in the neural foramen, just above the opening for the nerve root and outside the epidural space Use of a contrast dye helps to confirm where the medication will flow when injected. This method treats one side at a time. It is preferred for patients who have undergone a previous spine surgery because it avoids any residual scars, bone grafts, metal rods, and screws.

Interlaminar ESI (from the back). A needle is placed between the lamina of two vertebrae directly from the middle of the back. Also called interlaminar, this method accesses the large epidural space overlying the spinal cord. Medication is delivered to the nerve roots on both the right and left sides of the inflamed area at the same time.

  • Step 3: inject the medication

When the needle is in place, the local anesthetic and steroid medication are delivered to the epidural space. The needle is then removed.

What happens after treatment?

Most patients can walk around immediately after the procedure. After being monitored for a short time, you usually can leave the office or suite. Someone must drive you home.

Typically patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic (Tylenol).

You may want to record your levels of pain during the next couple of weeks in a diary. You may notice a slight increase in pain as the numbing medicine wears off and before the corticosteroid starts to take effect.

Patients should schedule a follow-up appointment with the referring or treating physician after the procedure to document the efficacy and address any concerns the patient may have for future treatments and expectations.

What are the Results of a Disc Injetion?

Many patients experience pain relief benefits from a disc injection. For those who experience only mild pain relief, one to two more injections may be performed to achieve full effect. Duration of pain relief varies, lasting for weeks or years. Injections are done in conjunction with a physical therapy and/or home exercise program to strengthen the back muscles and prevent future pain episodes.

What are the risks?

Disc injections are considered an appropriate nonsurgical treatment for many patients. The potential risks associated with inserting the needle include spinal headache from a dural puncture, bleeding, infection, allergic reaction, and nerve damage / paralysis (rare).

Side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (e.g., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.Follow us on social media: