Spinal Injections For Lower Back Pain

Spinal Injections For Lower Back
Thank you for joining us for today’s livestream where we talked about spinal injections for lower back pain. This video has been informed through a few studies so we’ll pop the links to these at the bottom of the description if you’d like to read the full papers.

Why are injections used?
If a person can’t move, they might be offered epidural or facet joints injections. There’s no difference in the actual injection itself, it’s just the placement of where it’s being injected. If you have a disc problem and it’s been injected into the facet, do ask the question why if this is you. They might be used as a diagnostic method rather than a treatment method to see how your symptoms change. If your symptoms go away for a while, then their next step might be to suggest a discectomy. Understand why they’re doing them.

In one study 25% of cases, an incorrect placement of the injection was experienced. With that in mind, make sure that if you’re having them that they’re done under imaging so you can make sure it’s being injected into the right place.

What Is It Doing?
A steroid injection is simply injecting anti-inflammatory material into an injury. The aftercare for injections can be relatively poor. You need to combine it with rehabilitation in order to get a beneficial outcome. A lot of people in a lot of pain are offered steroid injections as a quick fix, but there are serious downsides to this method. You’ll need to do the rehab in order to have a long-term treatment plan. Starting rehabilitation within 30 days reduced the future need for a further injection according to another study.

How Does It Compare?
There are more effective therapies around nowadays. Such as PRP therapy or stem cells. These are generally classed as experimental at this stage but they show much more documented promise than the evidence base for injections that exists at this time. If you’ve had steroid injections in the past, do let us know your experience with it. Chances are if you’ve had multiple injections in the past, you probably needed more than one because of a lack of rehab.

The questions we answered today were:

Is there the possibility that Steroid injections may worsen your back injury in the same way that taking painkillers and carrying on with your regular routine may be causing damage without you knowing?
Yes, there might be tissue damage, especially if it’s injected in the wrong place. It reduces pain temporarily but not in a way that’s going to resolve the problem and this is often misunderstood.

I’ve got a long history of back pain, I’ve had a discectomy and now have another disc bulge. Do you think I would be able to go back to running?
Yes, doing strengthening up to the point where your body is much stronger might take a few months, but after this you could then move on to a crosstrainer to build your cardiovascular fitness. You can then start to integrate some treadmill work after a couple of months. The treadmill sessions would be around 5-10 minutes at first, but you should be running faster for a shorter period of time to reduce the pounding on your discs. Work up to running at around 9-10km/h before you take it outside.

If you have an epidural for childbirth, could this cause you issues with back pain in the future?
You’re likely not sitting still at this time, it certainly wouldn’t be done on an image guided X-ray. It might not do any long-term damage, you’ll need to go through the necessary rehabilitation. If you’ve had a cesarean even more so as it ruptures the entire core muscles.

Would steroid injections be appropriate anywhere else in the body?
The same advice would be the case for other areas of the body. There is a financial incentive to keep them around as they can be easily duplicated and mass produced. PRP therapy and stem cell therapy cannot.

If steroid injections help to relieve pain in the short-term, whereabouts would you start with rehabilitation - phase 1 or phase 2?
If you’re not able to walk and you’ve had a steroid injection, start with phase 1. If you’re able to move around and contemplating having one, I would start with phase 2.



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[lisalightfoot]

Wow, I'm so glad I found you today. In Dec 21.I had severe instant pain that basically rendered my legs useless for a few months.i was already disabled having had lymphoma and a one of the secondary tumors was wrapped around my spine. Nerve damage is all I'm told. After my legs going in December I went to a&e and was given an x-ray. And since telephone calls asking l, has my appointment come through for steroid injects in the lower spine.i haven't seen anyone since for this. The answer is still no. No info, all I was told was it will hopefully get rid of the pain. Having had chemo injections in that area and listening to your talk I really don't think they have taken my previous and ongoing problems into account. I think I will now contact them to ask if this is the only option for me. Thank you.

[helenadeakin]

Informative video. When my injection was offered I couldn't walk and was in pain. The actual appointment came a few months later, after which time I did daily rehab with Back in Shape. So I probably didn't need it anymore and went ahead out of curiosity to see if the rest of symptoms go away. It didn't in my case if fact, I feel more tingly in my leg, luckily haven't lost the strenght I've build up. So, carrying on with my rehab and hopefully the additional tingling will disappear soon. Thank you

[ellieantar]

Thank you for pointing out the pros and cons and what to ask if considering the injection

[mattymobbs]

Not sure now I had it in my lower back. But now my upper back hurts

[mattymobbs]

I have one but now my upper back realy hurts is that normal please

[kams]

How would stem cell treatment work? Injected directly into the disc? Or surrounding joints

[mattymobbs]

My one only ment to last 2 days then ment to go back for a longer lasting one