Spine Pain & Treatments – Epidural, Injections, Spinal Blocks | MedStar Orthopaedic Institute
physical therapist working with patient to relieve spine pain

Different kinds of pain respond to different kinds of treatment. You may have already found things that work well to relieve the pain. You may have tried relaxation, meditation, heat, cold, or mild exercise. These may all relieve some kinds of spinal pain. If so, your doctor will want to include these therapies in your treatment plan.


Epidural injections

Epidural steroid injections

These are injections of anti-inflammatory and anesthetic medications into the spinal canal. They're used to decrease swelling and the pain associated with it. Candidates for this procedure suffer from herniated/bulging or degenerated discs.

Epidural lysis of adhesions

An epidural lysis of adhesions helps decrease chronic low back pain due to adhesions and scar tissue formation. The physician inserts a catheter into the epidural space in the spine. Guided by real-time X-ray imaging, the catheter can be directed precisely to the affected nerve root. Once the tip of the catheter is in place, medication can be injected to relieve pain at the source and dissipate the scar tissue.

Spinal blocks

Facet joint blocks

Facet joints are located on the back of the spine where the vertebrae overlap. They help guide the movement of the spine. Facet joint blocks are also anti-inflammatory and anesthetic medications that are injected into the joint itself and its supporting structures. Fluoroscopy—x-ray imaging of a part of the body—is used to assure the proper placement of the needle. Patients with degenerative disc disease and increased weight and pressure on the joint will benefit from the procedure.

Nerve root blocks

These are injections to relieve pain in the nerves that exist directly off the spinal cord. The nerve that's causing the pain is pinpointed and blocked.

Radio frequency ablation (RFA)

Patients who feel relief from nerve root injections but still have recurrence of pain may also receive Radio Frequency Ablation (RFA) of the nerve. During RFA, the painful nerve is identified and is connected to a computerized machine that heats the nerve to eliminate the nerve's function.

Sacroiliac joint injections

These are anti-inflammatory and anesthetic medication injections to reduce inflammation and discomfort in the hip joint.

Intradiscal electrothermal therapy (IDET)

A hollow needle is inserted into the painful disc. A thin heating wire (electrothermal catheter) is passed through the needle into the disc. The needle is heated, and destroys the pain receptors, eliminating the pain in the disc. This procedure can help patients with chronic disc pain who wish to avoid surgery, or for patients whose previous surgery has been unsuccessful.