Most of us deal with some amount of joint pain and back pain in our daily lives.As we live and function we place stress on our spine and joints, and over time breakdown can occur, causing pain and dysfunction. In most cases the pain will go away with some rest, ice, or over-the-counter medications.When the pain becomes persistent or interferes with our daily lives and function, we will often seek help from a trained professional. Treatment for things like back pain and joint pain can often be done with prescription medications such as anti-inflammatory, and exercise (i.e. physical therapy).These treatments help focus on managing the pain, reducing swelling, and retraining the muscles and joints.This allows for a patient to return to their level of function prior to the injury, and manage the symptoms over a long period of time. In some cases, when more conservative treatments are not helpful, consideration for an injection may be done.
In the case of joint pain, many times the diagnosis is done with a physical exam and imaging, such as an x-ray or MRI.This will help the doctor look at the bone structures and the soft tissues around the joint to see what could be causing the problem.An injection for a joint (i.e. knee, shoulder) is considered when the patient has not improved with medications or therapy.An injection for a joint is done under aseptic and sterile conditions by a trained professional. Many times the injection is done in the office, with a mixture of a local anesthetic and steroid.The local anesthetic numbs the area, and can help provide information about the source of the pain. Many times, the patient will note immediate relief from this.The steroid component of the injection helps reduce the inflammation in the joint, and provides a longer-term relief for the patient.
Injections for back pain follow similar treatment protocols for joint pain.When a patient presents with lower back or neck pain, medication and rest are initially considered, and then a course of physical therapy is recommended.When these treatments are not helpful an injection is considered.A picture of the spine is obtained to help visualize the cause of the pain. In many cases the cause of neck pain or lower back pain is found to be a herniated disc or a pinched nerve. In cases like this, an epidural may be considered. This is an injection that is done around the nerve and disc. It is done under sterile conditions, with a live x-ray to guide the doctor doing the procedure. The injection will often contain a mixture of steroid, local anesthetic, and sterile normal saline.The injections goal is to help reduce swelling around the nerve and disc, and improve the symptoms of pain that can come from neck and lower back pain.
All injections, whether joint or spinal, should be done with a trained professional. Discussion regarding the risks and benefits should always be had with the patient, and should only be recommended when more conservative treatment are unsuccessful. The goal of any treatment, be it medications, therapy, or injection, are to improve quality of life, pain, and function.The decision for treatment needs to be achieved as a team, with your doctor and you.
Dr. Steve M.Aydin practices at Manhattan Spine & Pain Medicine, 540 Bordentown Ave., second floor, South Amboy. For more information, call 732- 721-7227.