At times it is difficult for a physician to determine what is causing a patient’s low back or leg pain. One potential cause is a problem with one of your intervertebral discs, the gel-filled cushions that separate your spine’s bones (vertebrae).
If your doctor suspects that an intervertebral disc is causing your pain, he or she may recommend an injection to:
- Help identify the cause of the pain
- Possibly treat the disc pain
Purpose of diagnostic intradiscal injections: If your physician can’t determine the specific cause of your pain using diagnostic imaging, such as an MRI or CT scan, temporarily numbing the suspicious disc may help to identify the source of the pain.
Purpose of therapeutic intradiscal injections: Your doctor injects a steroid medication to decrease inflammation within a disc, thereby relieving pain. The steroid usually starts to work two to three days after the injection, with full results within one to two weeks. The pain relief varies for each individual, from no relief to long-term pain relief.
Overview of the intradiscal injection procedure
Here’s what to expect during an intradiscal injection procedure:
- Before the procedure, you’ll get an intravenous (IV) line placed in your arm, so you can receive fluids and medicine during the procedure.
- You will lie face down with a pillow underneath your abdomen.
- The injection area is cleaned and numbed before the injection.
- Using fluoroscopic (X-ray) guidance, your physician will determine the appropriate path for the needle.
- Your doctor will insert a thin needle to the center of each disc to be injected.
- Next, your doctor will inject a small amount of contrast dye to make sure that the medication will flow exactly where intended
- Then, your physician will inject a small amount of anesthetic, steroid, or a combination of both, depending on the procedure’s purpose.
- After the procedure, you’ll spend 30 to 45 minutes in the recovery area.
Preparing for intradiscal injection
- While the procedure may take less than 30 minutes, you should allow for at least one to two hours at the procedure center.
- You need to arrange for a driver to be present and take you to and from the medical facility. If you do not have a driver with you, we may have to reschedule your procedure.
- The evening before your injection, shower or bathe with antibacterial soap, if possible.
- If you are taking prescription blood thinners such as Coumadin (warfarin), Ticlid (ticlopidine), or Plavix (clopidogrel bisulfate), among others, please inform your patient care coordinator. These medicines will need to be stopped before the procedure, but only after you receive permission from the doctor who is prescribing these medicines.
- Tell your doctor’s patient care coordinator if you are on high doses of aspirin (more than two per day).
- Please tell us if you have any known allergies, since we will be using medications and contrast dye during the procedure.
- If you develop a fever, night sweats, or an active infection before your procedure, your procedure will need to be rescheduled. Please contact our office at (651) 968–5201 immediately to let us know about the symptoms you’re experiencing.
Possible side effects of the steroid
Side effects of steroid injections are usually minimal and go away within one to three days after the procedure. Possible side effects of the steroid include:
- Facial flushing
- Fluid retention
- Low-grade fever (less than 100° F)
- For women, temporary changes to your menstrual cycle
- For people with diabetes, temporary elevation of blood sugar levels
- Elevated blood pressure, for people with high blood pressure (hypertension)
After the intradiscal injection
- Follow the specific instructions given to you by the nurses at the procedure center.
- Plan to rest for the remainder of the day. You may resume light activity that is comfortable for you, but do not overexert yourself the first day.
- For discomfort, apply ice packs to the injection site for 15 minutes several times a day.
- Do not soak in a tub for 24 hours after the procedure. You may take showers.
- Report any signs of infection or other unusual symptoms to our office, including:
- Redness and warmth at the injection site
- Increasing pain
- Swelling or drainage at the injection site
- Chills, night sweats, or fever that reaches above 100° F
- Keep a record of your pain and symptoms after the injection and report your results as instructed by your doctor’s patient care coordinator.
Remember that your usual pain may go away for a few hours, but after the local anesthetic wears off, it is normal for your pain to return. The full effects of the steroid may take two days to two weeks to work, and its lasting effects vary from person to person. You may also have some temporary discomfort at the puncture site.
Potential risks of intradiscal injection
This study is considered invasive and does have potential risks. These include, but are not limited to:
- Pain at the injection site
- Infection in the disc
- Nerve injury
- Allergic reaction to medications or contrast dye. Be sure to inform us before the injection if you have any known allergies.
If your procedure includes sedation
We use conscious sedation, which means that you will be relaxed and comfortable during the procedure but will not be unconscious.
- You should have no solid foods for six hours before your procedure.
- You may have clear liquids up to two hours before your procedure. Examples include:
- Clear fruit juices such as apple, cranberry, and grape juice (no pulp)
- Tea, black coffee with no cream
- Carbonated beverages
- Nothing by mouth, including throat lozenges, mints, and all hard candy, for two hours before your procedure.
- No gum for two hours before your procedure.
- You must have a responsible adult arrive with you to our facility and drive you home. If you use a taxi or volunteer ride service, you still must have a responsible adult with you in order to help take care of you after your procedure.
- Please take your regular medications the day of your procedure, especially any heart, diabetes, or blood pressure medications.
Summit Orthopedics offers comprehensive spine expertise
Summit’s spine care team is recognized by the National Committee for Quality Assurance for the comprehensive expertise of our patient-centered care. Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
Ask the Expert: Spine Video Series
Dr. Choi treats patients with chronic back pain, and she explains the range of nonsurgical therapies available to relieve 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.