You must remember that there are two types of injections: diagnostic injections and therapeutic injections:
1. Diagnostic injections are performed because it is nearlyimpossible to be 100% sure about the exact diagnosis by history and physical examination alone. The goal is to precisely place local anesthetic (numbing medication) around or inside the suspected source of pain. If you obtain significant relief from this injection, it is likely that the true diagnosis has been found.
2. Most therapeutic injections use a powerful anti-inflammatory medication (corticosteroids). The goal of the injection is to place a small amount of this potent anti-inflammatory medication exactly where the pain begins (e.g. joint, nerve). The goal is to precisely instill this medication where it will provide the greatest benefit to your spine problem.
The quality/efficacy of the spinal injections is practioner specific; base upon a combination of knowledge and skill. The treating physician must possess both to effectively treat spine pain patients.
For a diagnostic injection to be accurate it must block the target structure completely without blocking other spine structures that are only millimeters away. The specialist must place the needle safely within a millimeter of the target and deliver just enough medication (no less/no more) to bathe that structure without unpredictable spread to other structures. This requires not only manual skills, but also an understanding of spinal anatomy and the latest scientific literature to know exactly where to place that needle.
For a therapeutic injection, the goal is to place a small amount of medication at the exact source of pain. No matter how proficient the physician is at performing injection procedures, the skill is useless if the medication is injected at the wrong location. In choosing the correct location the spine specialist is required to utilize the information he/she acquired from the history, physical examination, radiological images, as well as the most up to date medical literature to identify the most likely anatomical source of your pain. If you are suffering from joint pain and the physician performs a nerve root block, you are not going to get results.
Evaluating and treating spine pain is a complex process that seems simple at first glance. The same can be said for the spinal injections themselves. If you are contemplating undergoing minimally invasive spine management make certain a qualified practitioner is treating you.
