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Patient Procedure Forms

Home > Conditions & Treatments

Spine Injections for Pain Management

Condition

Treatment

• Cervical Facet Block and Steroid Injection (CFBSI)
  
• Cervical Nerve Block and Steroid Injection (CNBSI)
  
• Lumbosacral Nerve Block and Steroid Injection (LSNBSI)
  
• Lumbosacral Facet Block and Steroid Injection (LSFBSI)
  
• Lumbosacral Epidural Steroid Injection (LSESI)
  

When should I consider Spine Injections?
The two major reasons to perform these procedures are to determine whether particular nerves or joints are causing your symptoms, and to provide temporary pain relief. Although these goals are usually achieved, it is impossible to guarantee that the cause of your pain will be identified, and that your pain will be decreased. The period of relief is different in each patient.

What should I expect BEFORE Spine Injections?
Please call us 24 hours ahead of time if you need to cancel or reschedule your appointment: 617-726-7717. We will be calling you before your appointment to screen you for anything that may interfere with the procedure and will ask you the following questions:

• Are you allergic to x-ray dye (contains iodine)?
• Do you have diabetes?
• Do you take Coumadin or other blood thinners?
• Are you being treated for an infection?
• Do you weigh more than 450 pounds?

Please bring your most recent MRI or CT scans of your spine to the procedure, as well as a list of current medications and doses you are taking. If your symptoms are mild, do not take pain medications before the procedure. Please arrive 30 minutes prior to your appointment.

What should I expect DURING Spine Injections?
The procedure takes about 30 minutes. Depending on the procedure, you will either lie on your stomach or back and must be able to turn your head. Your skin will be cleaned with an antiseptic soap, and then numbed with a local anesthetic. Using fluoroscopy (continuous x-ray), the radiologist will pass a needle into the area of your back that is believed to be causing your pain. A very small amount of contrast dye will be injected to confirm correct needle position, and then the medications will be injected. During the injection, you may feel mild pressure or tingling. These sensations are expected and will only last several seconds. Please inform the radiologist if you feel these sensations, as it will help to diagnose the exact source of your pain. Two different medications are injected around the targeted area. A short-acting anesthetic agent is injected for diagnostic information. If your pain is relieved immediately following the procedure, it will come back after the anesthetic agent wears off in about 1 to 5 hours, depending on the specific area being treated. An anti-inflammatory steroid is injected for longer-lasting pain relief, but it will not begin working for 1 to 2 days. The steroid reaches maximum effectiveness in 5 to 7 days. The duration of relief depends on many factors, including the severity and reversibility of your condition.

What should I expect AFTER Spine Injections?
You will receive discharge instructions and a pain diary to record the changes in your symptoms. You will not be allowed to drive, however you can leave the hospital immediately if you have someone who can drive you home and stay with you for up to 5 hours. The short-acting anesthetic can make your arms and legs feel numb or weak for up to 5 hours. You should minimize activity during this time, and then resume routine light activities as tolerated. You should not drive a car until your arms and legs feel normal. Avoid any strenuous activity or heavy lifting for 7 days.

What are RISKS associated with Spine Injections?
Complications are infrequent but possible. The needle could cause local bleeding or infection. Rare complications include allergic reaction to the x-ray dye or anesthetic medication. If the anesthetic spreads to nearby nerves, you may develop temporary arm or leg weakness or numbness. Pain may be temporarily worsened after the procedure.

Our Service

• William E. Palmer, MD
  
• Miriam A. Bredella, MD
  
• Ara Kassarjian, MD, FRCPC
  
• Susan V. Kattapuram, MD
  
• Hugue A. Ouellette, MD
  
• Daniel I. Rosenthal, MD, FACR
  
• J. Shannon Swan, MD
  
• Martin Torriani, MD, MSc
  

Where are Spine Injections performed?

Massachusetts General Hospital
Division of Musculoskeletal Imaging & Intervention
Yawkey Center for Outpatient Care
55 Fruit Street, YCOC 6 (YCOC 6 Floor Map )
Boston, MA 02114

How to schedule Spine Injections
A referral from a physician is necessary to make an appointment. Same day scheduling is available. Physicians may schedule patients using our online scheduling and report access program - ROE.

For detailed information, please contact the Musculoskeletal Imaging Division at:

Phone: 617-726-7717 or 617-724-7246 (4-PAIN)

To assist with scheduling please have the following information ready when calling:

• Name and phone number of the physician ordering the Spine Injection
• Indication for procedure
• Patient Medical Record Number (MRN)
  

Additional Information and Resources

• Image-Guided Pain Management, Part 2: Steroid/Anesthetic Injections for Musculoskeletal Pain - October 2007
• Vertebral Osteomyelitis - November / December 2006
• Bone Density and Osteoporosis - August 2005
• When is Imaging Helpful for Patients with Back Pain? - January 2004

• MGH Orthopedic Spine Center

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