CONSERVATIVE TREATMENT: INJECTION THERAPY
Injection therapy-In some cases, pain can be relieved by injecting pain-relieving drugs directly into the area of the spine where the pain appears to be localised. It can be effective for treating ‘trigger points’ (fibrositis), small, very painful nodules of muscle and/or fibrous tissue often in the buttocks, neck and shoulders, tension or pressure on which often spreads the pain over a wider area.
A corticosteroid drug may be injected, together with a local anaesthetic to limit the inflammatory process. The relief may not be immediate, or long-lasting, and a number of injections may be required for the treatment to be effective.
Epidural injections have been are used for pain which has not yielded to any other methods. These injections are given into the epidural space between the dural tube and the spinal canal, at the lower end of the sacrum. They consist of a corticosteroid drug mixed with a local anaesthetic. This numbs the tube, and reduces inflammation, such as that set up by a prolapsed disc. The injection cannot put right the prolapse itself, but in most cases time is the best healer for this, and epidural injections, like other pain-relieving measures, make the period of waiting seem less interminable.
Much backache arises from the facet joints. Pain originating in facet joints can radiate down the leg and mimic sciatica. In some cases, injecting steroids and a local anaesthetic into the joint can modify the pain. If relief is only temporary, the nerve to the facet can be destroyed, producing permanent relief. The technique is one which is reserved for experts.
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