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Spinal Injections

If an episode of lower back pain has lasted between two and six weeks, or if there are frequent recurrences of lower back pain, it is reasonable to consider back pain exercises and physical therapy for back treatment.

Some spine specialists consider back exercise and physical therapy sooner, particularly if the pain is severe.

In general, the goals of back pain exercises and physical therapy are to decrease back pain, increase function, and provide education on a maintenance program to prevent further recurrences.

Spinal injections

In many cases of chronic back pain spinal injections may be used both to find out what is causing your pain and to treat your pain. Doctors refer to these two separate uses of spinal injections as diagnostic and therapeutic.

If an injection provides pain relief in the area that is injected, it is likely that this particular area is the source of the problem and therefore it is diagnostic. Injections are also therapeutic in that they can provide temporary relief from pain.

Medications

With most spinal injections, a local anaesthetic (numbing medication) called lidocaine (also known as Xylocaine) is injected into a specific area of the spine. Lidocaine is a fast-acting drug, but the effects wear off within about two hours. That is why lidocaine is used more often as a diagnostic tool rather than a long-lasting pain reliever. Bupivacaine (also known as Marcaine) is another type of anaesthetic that can be used. It is slower to take effect, but it lasts longer, giving the patient more relief from pain.

Cortisone is a strong anti-inflammatory steroid medication. It is commonly injected along with a local anaesthetic in order to reduce inflammation in the affected areas. Cortisone is long lasting and can be slow-releasing in order to give the best possible benefits of pain relief. Cortisone may not begin working for several days following the injection, but the effects can last for months. Sometimes a narcotic medication such as morphine or fentanyl is mixed with cortisone and the anaesthetic to get increased pain relief.

What to expect

Where chronic back pain is experienced, spinal injections may be used to diagnose the cause of the pain as well as treat it. If an injection provides pain relief it is likely that the particular area is the source of the problem but injections also provide temporary relief from pain.

A local anaesthetic called lidocaine is injected into a specific area of the spine, the effects of which wear off within two hours, or Bupivaaine may be used as is lasts longer, providing the patient more relief from pain.

Cortisone is a strong anti-inflammatory steroid medication which is often injected, as well as a local anaesthetic in order to reduce inflammation in the affected areas. It may not begin working for several days following the injection but its effects can last for months.

Patients with disc prolapse are offered early injection treatments to eradicate sciatica and back pain. All spinal injections are performed under sedation and fluoroscopy to ensure accuracy and minimal discomfort. Patients failing to respond to injections undergo keyhole surgery to remove the prolapsed disc.

Preparations for your spine injections

Medications and your procedure

Routine Medications Take as normal.
Warfarin Stop taking this three days before your procedure. Alert your GP or specialist if this applies to you.
Clopidogrel or Plavix Stop taking this ten days before your procedure. Alert your GP or specialist if this applies to you.
Aspirin based medication Stop taking this seven days before your procedure. Alert your GP or specialist if this applies to you.
Allergies Please telephone 0844 589 2020 if you think you have an allergy to latex or any medication.

Eating & drinking before your procedure

On the day of your procedure, nil by mouth (fast from food) six hours prior to your procedure. You may drink clear fluids (water, tea and coffee without sugar or milk) up to three hours prior to the procedure.

Specific instructions for diabetic patients

Please inform the Ward about your diabetes.

On the morning of your procedure,

  • If you usually test your blood sugar levels, check them in the morning. Your blood sugar levels will be re-checked by the Ward nurses when you arrive.
  • If you are on tablets, do not take your morning dose of tablets. Bring your tablets with you to have after the procedure. Take your tablets as soon as the nursing staff advise you are able to eat and drink safely.
  • If you are on insulin, report to the nursing staff if you have needed glucose before arriving and inform them immediately if you feel ‘hypo’ at any time during your visit. Do not take your morning dose of insulin. Bring your insulin with you to have after the procedure. It can be given as soon as the nursing staff advise that you are able to eat and drink safely.

Read More:

Spine Clinic

The Spine Clinic at St John & St Elizabeth Hospital is a centre for excellence in the diagnosis, intervention and aftercare of all spinal conditions.

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Patient information

Our Hospital is renowned for providing exemplary levels of care across more than 90 services. From orthopaedics, to urology, our private GP practice and Urgent Care Clinic, our services are led by some of London’s leading Consultants. For more information, and to find a service suitable for your care, find out more about the services that we offer.

Make an enquiry

If you have any questions relating to treatment options or pricing information, get in touch with us by filling out one of our contact boxes or giving us a call on 020 3370 1030.

Our Appointments Team have a dedicated and caring approach to finding you the earliest appointment possible with the best specialist.

If you are self-paying you don’t need a referral from your GP for a consultation. You can simply refer yourself* and book an appointment.

If you have health insurance (e.g. Bupa, Axa Health, Aviva), you will need to contact your insurer to get authorisation before any treatment, and in most cases you will also require a referral letter from your GP.

If you are not registered with a GP, we have an in-house private GP practice you can use. Alternatively, we can suggest the most appropriate course of action for you to take, given your location and individual circumstances.

*Please note – for investigations such as X-rays and MRIs, a referral will be required. However, we may be able to arrange this for you through our on-site private GP.

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