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While joint replacements, arthroscopies, spinal surgeries, and local anesthetic procedures are happening in some of the operating rooms at The Orthopaedic Surgery Center (TOSC), our two physical medicine specialists (Dr. Vo and Dr. Zoeller) are performing an entirely different type of intervention in another room. They are helping our patients find relief from back pain without undergoing spinal surgery by performing epidural steroid injections and facet joint injections.

Epidural steroids injections (ESIs) and facet joint injections are two of the many treatments we offer in our Spine Center at Orthopaedic Associates of Wisconsin. These injections are similar in concept to getting a cortisone injection in your knee or shoulder.The cortisone is instead injected into the problematic area in and around your spine to help reduce inflammation that could be causing your symptoms. ESIs are used to treat pain caused by a nerve pathology while facet joint injections are used to alleviate discomfort associated with arthritis in the spine. These injections can be therapeutic in providing some relief of your pain, but they can also be used as another diagnostic tool to help further determine the root cause of your symptoms as spinal pathology can be tricky to diagnose if multiple pathologies exist. For example, a patient may have arthritic changes in his/her spine seen on x-ray, but an MRI might reveal inflammation around a nerve. The injection helps pinpoint if the pain is coming from the arthritis or the nerve.

Presenting to TOSC for one of these injections cannot first be done without proper clinical examination and work-up. If you are experiencing any symptoms that you think are related to your spine, you should schedule a consultation with one of our spine specialists. After proper evaluation as well as obtaining the necessary imaging (likely x-ray and MRI), your spine specialist physician may recommend an injection to be done at TOSC.

Having medication injected via a needle in close proximity to your spine can certainly sound like an intimidating experience. Worry not! We have experienced physicians who, along with the TOSC team, will provide you with a stress-free encounter. The procedure is done while you are awake. You will be positioned appropriately, and then one of our x-ray technologists will use what is called a C-arm, which is a live x-ray that allows for precise injection at the site of the pain generator. After sterile preparation of the injection site, the needle will be carefully inserted and the medication released. Oftentimes, initial relief will be experienced due to the numbing medication included in the syringe with the steroid. We don’t advise going for a run with your newfound relief, but daily activity as tolerated is certainly fine. In general, we recommend allowing 10-14 days before determining whether or not the injection was successful, at which point your physician will likely want to see you in clinic for follow-up evaluation. If the procedure was successful in alleviating your symptoms, you can then discuss repeating the injection in the future should symptoms arise.

If COVID has you working from home slouched on the couch rather than an ergonomically correct workstation, and you feel like you’ve exhausted medications, hot packs, ice packs, stretches, and other home remedies, call our office for a consult in our Spine Center to get on the road to relief from nagging back pain!