ORTHO THERAPY
NOT BODYBUILDING
Corticosteroids are designed to replicate anti-inflammatory hormones.
Corticosteroids are man-made drugs that closely resemble cortisol, a hormone that your adrenal glands produce naturally. Corticosteroids are often referred to by the shortened term “steroids.” Corticosteroids are different from the male hormone-related steroid compounds that some athletes abuse.
Therapeutic steroids
- Consist of steroid injections which introduce corticosteroids into the area of pain. Corticosteroids are designed to replicate anti-inflammatory hormones.
- There are different types of steroid injections that are classified based on where they are injected.
- Steroid injections may reduce pain and restore mobility.
INJECTIONS FOR SPINE PAIN
- Epidural Injections: This is an injection for the spinal canal that surrounds the spinal cord. It is commonly used to treat sciatica.
- Trigger Point Injections: An injection for muscles in the back to reduce inflammation and pain in the back, hip, or legs.
- Facet Joint Injections: The facet joints are the joints that connect vertebra to one another. This injection can reduce inflammation and pain in the back.
- Sacroiliac joint injection: The sacroiliac joints are the joints that connect the pelvis to the spine. This injection can reduce inflammation and pain in the sacroiliac joint.
THE STEROID
INJECTION PROCEDURE.
EPIDURAL STEROID INJECTIONS
Epidural steroid injections are injected above the dura, the outer most layer covering the spinal cord and the nerves exiting the spinal cord.
Conditions that can cause acute or chronic back pain that can be treated by steroid injections include:
- Lumbar disc herniation
- Degenerative disc disease
- Lumbar spinal stenosis
- Cysts in the facet joint, the nerve root that can expand to spine structures
- Annular tear, tear in the outer disc
This treatment option can give relief from one week up to one year. If proven successful, a patient may have up to three epidural steroid injections in one year.
We perform this procedure in our offices or at surgery centers. The patient will lie down on his or her stomach, and the orthopedist will use a local anesthetic to numb the area around the injection site.
Using fluoroscopy, which involves real-time, moving X-rays, the surgeon guides the needle to the correct location, then injects the steroid mixture. Once the needle is removed, the patient will be monitored for a short time before being discharged. Patients are asked to rest for the remainder of the day and can use an ice pack at the needle insertion site if it is feeling tender.
A temporary increase in pain can occur for several days after the injections due to the pressure of the fluid injected or a chemical irritation. Only a very few patients report a spinal headache after the procedure; this is due to a dural puncture that occurs in 0.5 percent of injections. It usually goes away in a few days, but infrequently a blood patch is needed to alleviate the headache.
SACRO-ILIAC JOINT INJECTIONS
Sacroiliac joint injections, also known as sacroiliac joint blocks, are primarily used to diagnose or treat lower back pain and sciatica symptoms associated with sacroiliac joint dysfunction. Pain in the lower back and legs can be caused due to too much or too little movement in the sacroiliac joints. The two sacroiliac joints are located next to the spine and connect the spine with the hips.
The typical injection procedure will begin with the patient lying face down and the injection site is numbed. Under X-ray or ultrasound guidance, the doctor will place the needle into the sacroiliac joint, confirm the placement and then inject a small amount of anesthetic with a corticosteroid.
The anesthetic is used for the diagnostic portion of this injection. If the pain is eliminated, then we learn that this area was the pain generator and we have been able to diagnose sacroiliac joint pain. Then the corticosteroid reduces the inflammation, which is usually the cause of the pain, and that is the therapeutic portion of this treatment.
After the procedure, the patient will stay at the doctor’s office for a 30-minute observation period and is then released to go home and rest.
