Spinal and Thoracic Injections

What is a Spinal/Thoracic Injection?

A spinal or thoracic injection is a targeted pain management treatment that delivers medication directly to the source of pain in your spine. These injections typically contain a combination of local anaesthetic and anti-inflammatory medication (corticosteroid) to reduce inflammation and relieve pain.

The treatment particularly benefits patients experiencing chronic back pain, nerve pain (sciatica), or spinal inflammation. It can help those who haven't responded well to other treatments, such as physiotherapy or oral medication, and those looking to manage pain while working on longer-term solutions.

How Spinal/Thoracic Injections Work

The procedure uses precise needle placement, often guided by X-ray imaging (fluoroscopy) or ultrasound, to ensure the medication reaches the exact area causing pain. Different types of injections target specific areas:

• Epidural injections target the space around the spinal cord
• Facet joint injections treat the small joints between vertebrae
• Nerve root blocks target specific nerve roots where they exit the spine
• Sacroiliac joint injections address lower back and buttock pain

The medication reduces inflammation and interrupts pain signals, providing relief that can last several months.

What to Expect When Receiving Spinal/Thoracic Injections

Before Your Treatment:
Before your spinal injection, you'll have a detailed consultation to review your medical history and imaging results. Your specialist will provide instructions about stopping certain medications, such as blood thinners, if required. Fasting may be necessary if sedation is planned. You'll need to arrange transport home, as you won't be able to drive after the procedure.

During Your Treatment:
During the procedure, which takes 15-30 minutes, you'll lie face down on an X-ray table. Your specialist will use local anaesthetic to numb the injection site before proceeding. X-ray guidance ensures precise needle placement throughout the procedure. While you may feel brief pressure or discomfort, the treatment is generally well-tolerated.

After Your Treatment:
After your injection, you'll be monitored for 30-60 minutes in our recovery area. You'll need someone to drive you home, and you should rest for the remainder of the day. Keep the injection site clean and dry, and monitor for any unusual symptoms. Your healthcare team will provide specific aftercare instructions before you leave.

Risks and Complications of Spinal/Thoracic Injections

While generally safe when performed by experienced specialists, potential risks include:

• Temporary increase in pain
• Infection (very rare)
• Bleeding or bruising
• Headache
• Allergic reaction to medication
• Temporary numbness or weakness
• Nerve injury (extremely rare)

Your specialist will discuss these risks and how they apply to your specific case.

How to Recover Following Spinal/Thoracic Injections

Recovery involves several stages:

Immediate (24-48 hours):

• Rest and avoid strenuous activities
• Apply ice to reduce discomfort
• Take prescribed pain medication if needed
• Keep the injection site clean and dry

Short-term (1-2 weeks):

• Gradually return to normal activities
• Follow any prescribed exercise programme
• Monitor your pain levels
• Attend follow-up appointments

Long-term:

• Maintain good posture and back care
• Continue with the recommended exercises
• Keep track of how long pain relief lasts
• Plan follow-up treatments if needed

References

NHS: Back Pain

National Institute for Health and Care Excellence (NICE): Low Back Pain Guidelines‍