A spine injection is a non-invasive method for relieving chronic back pain. While pain injections have been around for many years, medical advances continue to improve outcomes and widen the scope of available treatments. These days, a spine doctor has more treatment plans from which to choose, and that means patients have more options.
At the Weill Cornell Medicine Center for Comprehensive Spine Care, we continue to conduct research into the effectiveness of epidural injections, while pioneering stem cell therapy that promises to revolutionize the treatment of various spinal conditions. Before speaking with a physician and settling on a course of action, it’s important to understand each alternative.
Spine injections are a non-surgical method for treating severe back pain. “Spinal injections are targeted therapy that helps reduce pain coming from the spine,” says Jaspal Ricky Singh, MD, a leading sports medicine and pain specialist at the Weill Cornell Medicine Center for Comprehensive Spine Care. They work by suppressing inflammation around an aggravated nerve and by blocking the nerve signals between a specific area of the body and the brain. 1 By providing temporary relief in a safe and effective manner, steroidal injections help patients resume their normal routine.
Epidural pain injections alleviate symptoms for a few months, at most, meaning they do not usually provide a long-term solution for chronic back pain. Permanent relief typically comes from a combination of lifestyle changes and intense physical therapy. That being said, many patients need the injections in order to get through their therapy routine. According to a paper co-authored by Dr. Singh, physicians typically prescribe both as a means of managing conditions such as symptomatic lumbar spinal stenosis. 2
A spine doctor will typically recommend pain injections after trying traditional medications but before resorting to surgery. Patients who cannot or do not wish to undergo spine surgery may use pain injections to improve function while they seek more natural ways to rehabilitate their bodies. 2
Types of Epidural Injections
A spine doctor can administer injections to two different sites, depending on the type and location of the pain.
- Interlaminar ESI: Administered directly to the back of the spine, between two vertebrae. Circulates the steroids over a wide area.
- Transforaminal ESI (TFESI): Injected into a nerve root that emerges from the side of the spine. Concentrates the steroids in a specific nerve.
If TFESI is appropriate, a physician may recommend one of two types:
- Single– Level TFESI: Targets the nerve roots at a single level. Designed for concentrated pain.
- Two– Level TFESI: Targets two different levels of nerve roots. Preferred for diffuse and severe pain. 3
Two-level TFESIs may be appropriate for severe pain, but doctors should use caution when prescribing them, given the risk of serious complications. In many cases, a single-level injection is sufficient, even when pain is spread over two levels. 4 If your physician has recommended a two-level TFESI, don’t be afraid to inquire into the reasons and ask them if it’s necessary. If you feel you need a stronger dose, be sure to weigh the risks against the potential benefits.
Stem Cell Therapy
Stem cells have shown great promise in regenerating damaged cells, allowing the body to heal itself. The procedure involves extracting a patient’s own bone marrow and injecting it into the irritated area. When administered into the spine, it is possible to promote healing of damaged discs, providing relief without resorting to the more invasive option of surgery. 5 While still a relatively new method for treating back pain, stem cell therapy provides great hope for the future of spinal treatment.
Comprehensive Spine offers both epidural injections and stem cell injections. Schedule a visit with a spine specialist to discuss your options for pain management and treatment.
Providing a complete continuum of care—from diagnosis to treatment to recovery—the expert team at The Center for Comprehensive Spine Care at Weill Cornell Medicine is committed to helping patients live better lives with less pain.
Our state-of-the-art facility serves as a centralized location, providing patients with access to world-class specialists in neurology, pain management, rehabilitation medicine, and neurological surgery.
- Weill Cornell Medicine: Jaspal Ricky Singh M.D. “Spine Injections.” < http://www.rickysinghmd.com/jaspal-ricky-singh-md/>
- The Spine Journal. “Effectiveness of Physical Therapy as an Adjunct to Epidural Steroid Injections in the Treatment of Lumbar Spinal Stenosis: A Pilot Randomized Controlled Trial.” http://www.thespinejournalonline.com/article/S1529-9430(12)00941-2/pdf
- Weill Cornell Medicine Center for Comprehensive Spin Care. “New York City’s Interventional Spine Injections.”
- Weill Cornell Medicine Center for Comprehensive Spine Care. “Low-Back Pain Treatments: The Experts Weigh In.”
- Weill Cornell Medicine Center for Comprehensive Spine Care. “Two Approaches to Transforaminal Epidural Steroid Injections for the Treatment of Radiating Low-Back Pain: What is the Evidence?”
- Weill Cornell Medicine Center for Comprehensive Spine Care. “Regenerative Medicine.”