Ask Dr. Santos: How Do Injections Help Diagnose Back Pain?

At Summit, injections are one of the conservative treatments offered for back pain. Dr. Santos explains how injections can be used to diagnose, as well as treat, a painful back condition.

When a patient comes to Summit spine surgeon Dr. Edward Santos with a back pain complaint, diagnosis can be challenging. There are a host of conditions that generate back pain—and sometimes the location where the pain is felt is not the underlying source of the problem. Dr. Santos explains how an injection can help him confirm a diagnosis. 

“My job is to accurately identify the source of my patient’s back pain,” explains Dr. Santos. “That is often the challenge. Whether pain can be treated with conservative therapies or requires surgery, my first task is to really decipher and figure out the source of the pain.

“Diagnosis begins with the history and physical exam, which are the most important components of the diagnostic process,” he continues. “After I arrive at a presumptive diagnosis based on history and examination, I then may use X-rays and other imaging modalities for confirmation. In addition, I have found injections very helpful for diagnostic purposes. If I suspect that one specific level or structure of the spine is symptomatic, I might use an injection in that area. If the injection gives the patient some relief, we have evidence that we are targeting the correct area of the spine for treatment.”

An epidural steroid injection can be given at the office and usually takes between 15 and 30 minutes. Here’s what you can expect:

  • The patient lies flat on an X-ray table. If the prone position is painful, the patient may be able to sit or lie on his or her side for the injection.
  • The skin at the injection site is cleaned and then numbed with a local anesthetic.
  • Using fluoroscopy for guidance, the physician inserts a needle into the skin and directs it toward the epidural space.

“If the injection provides the patient with good—if temporary—relief, we have an indication that this is the spot causing the pain. Injections are helpful for diagnosis and for pain relief. Studies have shown that a significant percentage of patients receive some pain relief as the result of a lumbar epidural steroid injection, with effects lasting from a week to up to a year. The pain relief benefits of injections can improve a patient’s quality of life, minimize the need for pain medications, and potentially delay or avoid surgery. I want to help my patients reclaim their quality of life, and injections are one of the medical resources I have to accomplish that goal.”

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  • Edward Santos, M.D.

    “I am committed to providing the best care possible for all of my patients with spine disorders. I treat each and every patient as I would treat any member of my family. I believe that patients’ concerns and expectations deserve to be heard. I also believe in the importance of having a thorough discussion of both surgical and nonsurgical options, with the goal of relieving pain and restoring function.”

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