Florida Spine & Pain Institute

TREATMENTS

Joint Injections

Facet joints form where each pair of spine bones (vertebrae) meet. These joints help your spine move, twist, and stay flexible. The facet joints are tiny joints near the back of the spine that connect each vertebrae. They also allow nerves to pass from your spinal canal to every other part of your body.

If your joints are damaged or inflamed due to an injury or a disease like arthritis, you can wind up with chronic pain and stiffness. Injections of corticosteroids and anesthetics reduce these painful symptoms. These injections can also be used to diagnose spine issues affecting your joints and nerves.
Not every injection is guaranteed to help patients, and depending on how severe your pain is, you may need to consider more aggressive treatments. However, the majority of those who undergo some form of injection therapy describe their experience very positively. Besides reducing your symptoms, you can expect benefits such as:
 
  • Faster relief
  • Shorter procedure
  • No scarring
  • Less painful
  • Minimal side effects
  • Little to no downtime

The types of joint injections available can vary based on the joint affected, any underlying conditions and your level of pain. There are 6 primary types of joint injections commonly given as pain management.

An epidural steroid injection is used primarily to treat pain in the lower back area. This region is also known as the lumbar spine. Just as an epidural can help relieve the pain of a laboring mother, an epidural injection is a good option for those experiencing frequent acute or chronic pain conditions.
During the procedure, a small needle is placed into the lumbar region of the back into the epidural space. The medicine is injected into this area. Combining the corticosteroid with a local anesthetic reduces the inflammation and swelling in the area to take the pressure off the surrounding nerves and tissues.
This procedure is usually done as a same-day procedure at an outpatient surgery center. Patients can receive light sedation during the procedure to ease discomfort further.
Facet joints are small joints located between vertebrae in the back or neck along the spine. Facet joints contain a covering of cartilage that facilitate the range of motion and stability in the spine. When this cartilage wears off over time due to friction and use, it leaves these areas vulnerable and causes pain.
Again, facet joint injections involve administering a steroid and an anesthetic agent like Lidocaine. This procedure can take about 15 minutes in the office. It involves using a live x-ray device called fluoroscopy to direct the needle placement for the injection.
Joint injections involving the medial branch help to block the sensory nerve located there. The medial branch nerve signals to the facet joints and causes pain. The medial branch joint injection uses steroids and anesthetic medicine to interrupt these pain signals.
With the pain receptors in this area stopped, patients experience a pain-numbing effect. This effect is only temporary for a few hours but it can provide as much as 70-80% pain relief on average.
A medial branch block is also a useful diagnostic tool to determine if a patient will benefit from a more long-lasting pain management procedure such as radiofrequency nerve ablation.

Viscosupplementation injections are most commonly used to target knee osteoarthritis areas but can also be effective for other joints. Using these joint injections is a step in pain management for pain management when more conservative routes have failed. The procedure can be done in the office with an ultrasound to help with chronic knee pain. Viscosupplementation joint injections can be used as a way to avoid surgery in knees with reduced natural joint lubrication and pain. It injects special gel-like natural protein materials into the knee joint. The gel material serves as a cushion inside of the knee to reduce friction and loosen up stiff and inflamed areas.

Ordinarily, your body creates hyaluronic acid in the joints and eyes. If you suffer from a condition like osteoarthritis, your joints are lacking this essential substance for lubrication. Receiving these joint injections replaces this vital fluid and helps reduce your joint pain and improves your range of movement.
The most common course of treatment is one joint injection per week for 3-5 weeks. These joint injections can be done in your pain management doctor’s office.
Corticosteroid joint injections are the most common type of joint injections. They use potent steroids to reduce areas of inflammation and discomfort in swollen, painful joints. These joint injections are best for small and specified areas of inflammation and pain.
Corticosteroids help treat a variety of inflammatory pain conditions and injuries. Common areas for injection include:

  • Shoulders
  • Hips
  • Hands
  • Fingers
  • Knees
  • Wrists
  • Ankles
  • Feet
Patients receiving corticosteroid injections can receive several months to years of relief from their worst areas of pain, depending on their condition. Corticosteroid injections can be given in your doctor’s office and can provide almost immediate improvement in pain management.