Trigger point injections. Sometimes, putting pressure on a certain spot in the back
(called a trigger point) can cause pain at that spot or extending to another
area of the body, such as the hip or leg. To try to relieve pain, a
local anesthetic, either alone or combined with a
corticosteroid, is injected into the area of the
back that triggers pain (trigger point injection).
Facet joint injections. A local anesthetic or corticosteroid is injected into a
facet joint, which is one of the points where one
vertebra connects to another.
Epidural injections. A corticosteroid is injected into the
spinal canal where it bathes the sheath that surrounds the spinal cord and
These injections can be done by an
pain management specialist, or a
How It Works
Local anesthesia is believed to break the
cycle of pain that can cause you to become less physically active. Muscles that
are not being exercised are more easily injured, so the irritated and injured
muscles can cause more pain and spasm and can disrupt sleep. This pain, spasm,
and fatigue, in turn, can lead to less and less activity.
reduce inflammation. So a corticosteroid injected into the spinal canal can
help relieve pressure on nerves and nerve roots.
Why It Is Used
Injections may be tried if you
have symptoms of nerve root compression or facet inflammation and you do not
respond to nonsurgical therapy after 6 weeks.
How Well It Works
Research has not
shown that local injections are effective in controlling acute or chronic low
back pain that does not spread down the leg.1
Trigger point injections
Possible side effects
include nerve or other tissue damage, infection, or excessive bleeding.
Facet joint injections
Possible side effects
include pain at the injection site, infection, excessive bleeding, nerve
damage, or spinal cord inflammation.
Epidural steroid injections
Rare possible side
effects include headache, fever, spinal cord inflammation, or infection.
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
These injections can be painful.
Most orthopedists and rheumatologists advise against repeated
injections of corticosteroids directly into joints, including joints of the
spine, because degeneration or damage to joint cartilage may occur.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Wildstein MS, Carragee EJ (2009). Low back pain. In GS Firestein
et al., eds., Kelley's Textbook of Rheumatology, 8th
ed., vol. 1, pp. 617-625. Philadelphia: Saunders Elsevier.