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Research Medical Library

Injections for Pain Management

By David A. Doward, MD

At JOI we offer a wide range of injections with the goal of eliminating your pain. This typically involves the application of a steroid local anesthetic mixture at the site of inflammation which is causing the pain. JOI has a procedure room within the facility to perform these types of injections.

A large number of these injections are used to treat patients with pain that stem from their spine. These include epidural steroid injections and selective nerve root blocks that target the inflammation associated with a pinched nerve. We also target other pain generators in the spine such as the facet joints, the sacroiliac joints and the discs. Sometimes patients can benefit from a series (usually 2-3) of epidural steroid injections which can give the best clinical outcome. This is done if the patient is in a significant amount of pain with a severely inflamed nerve. Multiple injections are necessary to wipe all the associated inflammation.
There are also special procedures which can be performed that do not utilize steroids and can eliminate your pain for an extended period of time such as a radio frequency ablation and spinal cord stimulators. Other injections are used to target pain stemming from the hip, knee, shoulder and ankle joints. These can involve the use of steroids, viscosupplements, platelet-rich-plasma and stem cells. Patients who cannot tolerate steroids for medical reasons can benefit from these alternative treatment options.

After these injections, patients are advised to minimize their activity level for 48 hours to give the medicine time to work. We recommend icing the injection site up to 4 times (20 minutes per session) the day of the injection. Steroid injections typically take 48 hours before patients start to feel better with peak effects within one week.