Why are injections used to treat pain?
Injections are useful in relieving pain and, in some cases, in making a diagnosis. For example, using nerve blocks helps determine the exact origin of your pain, which may not be clear with diagnostic imaging tests alone. Additionally, the same type of injection can also relieve chronic pain.
In addition to injecting anesthetics to reduce pain and corticosteroids to reduce inflammation, more advanced forms of long-term pain management such as radiofrequency ablation and spinal cord stimulation may also be used.
What types of nerve block injections are used to treat pain?
Nerve blocks usually involve a combined anesthetic and corticosteroid and are one of the most commonly used forms of injection as they provide effective temporary relief of pain. Other common injections include:
Caudal steroid injections target the lowest part of the epidural space in your back and help relieve pain caused by sciatica, herniated discs, or bone spurs.
Regenerative injection therapy encompasses a series of injection treatments designed to promote repair of damaged tissue. These injections include prolotherapy; platelet-rich plasma (PRP), which provides a mild neurolytic effect followed by a complex restorative process with biochemically induced collagen regeneration); (using autologous blood spun to separate platelets) and even stem cell therapies can be used.
Prolotherapy creates a proliferative, inflammatory reaction, which can be any of a variety of solutions (including dextrose/lidocaine, dextrose/phenol/glycerin, sodium morrhuate, and pumice), thereby producing new tissue at the fibro-osseous junction. Hormones and multiple growth factors mediate this complex process.
PRP relies on the injection of concentrated platelets that release growth factors to promote healing in non-healing soft tissues. Autologous blood is collected and centrifuged; The part containing high amounts of platelets is used and injected into the tendon and ligament connection points in the enthesopathy area.
Stem cell injection involves using autologous adult pluripotent mesenchymal stem cells from the individual’s bone marrow or fatty tissue as the proliferation solution.
Epidurals are one of the most well-known types of injections for back and lower body pain, and are especially helpful for pain caused by damaged nerves or inflammation.
Facet joint injections
Facet joints are small joints that line the inner surface of each vertebra. Facet joint injections help reduce pain immediately, and their effects are often extremely long-lasting.
Trigger point injections
Myofascial pain syndrome is a common musculoskeletal syndrome in which myofascial trigger point formation occurs at locations in muscle, fascia, or tendon. Trigger points are often associated with a taut band that is tighter on palpation than adjacent muscle fibers, an extremely uncomfortable tender point. When squeezed, it can cause a trigger point to make a noise or a visible retraction (known as a skipping sign).
Stretching and exercise are the basis of treatment and management of the disease. Trigger point injections target areas of knotted muscle that remain tight enough that you can feel it under the skin. Injections help in reducing such pain.
Dry needling (also known as intramuscular stimulation) is an effective method that involves the practice of using a small-bore needle to irritate the trigger point without injecting any substance.