Steroid blockade is one of the effective treatments for pain in the lumbar spine. An agent with strong analgesic and anti-inflammatory properties is given as an injection to inhibit inflammation in the area of irritated tissues (e.g. nerve roots or intervertebral joints). The injection results in pain relief that cannot be effectively reduced by other forms of conservative treatment or when the patient cannot undergo spine surgery.
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The causes of back pain
Lumbar spine pain is most often the result of bad habits related to prolonged stay in an incorrect sitting position or frequent lifting of heavy objects without active spine stabilization. Then it comes to repeated overloads leading to the development of degenerative changes in the spine.
The degenerative changes usually affect the intervertebral discs (discs) connecting the shafts of adjacent vertebrae. Each disc consists of a peripherally lying fibrous ring and a centrally lying nucleus. A sedentary lifestyle is conducive to situations where the natural lordosis of the lumbar region is lost and the spine remains unnaturally bent while sitting. This causes the pulp nucleus to press against the posterior part of the fibrous ring, which leads to gradual damage to its structure. The nucleus pulposus may extend beyond the circumference of the intervertebral disc and cause pressure on the nerve root.
In response to an overload of the spine, bone spurs (osteophytes) develop - most often around the intervertebral joints and on the edges of the vertebral bodies. Osteophytes can also conflict with the nerve root, causing radiating pain (to the buttock, thigh, and sometimes even to the foot).
As a result of overloads, there is also a progressive destruction of articular cartilage and secondary inflammatory and degenerative changes in the intervertebral joints that connect the articular processes of the adjacent vertebrae. The capsular-ligament apparatus of the intervertebral joints is richly innervated, therefore pathological changes within them can generate very severe pain. In response to pain, the tension of the paraspinal muscles increases, which further aggravates the problem and closes the so-called the vicious circle of pain.
Indications for injections of the lumbar spine (blockages of the spine)
The ingredient administered to the affected area is a drug with strong anti-inflammatory properties consisting of a mixture of Diprophos or Depo-Medrol with Lignocaine and Bupivakine. A spine blockage treats pain caused by the compression of a nerve root in the spinal canal or in the intervertebral foramen. More specifically, root pain results from a local inflammatory response triggered by mechanical irritation to the root. By reducing inflammation, back pain is reduced or completely eliminated. A blockage of the spine is also effective in people with pains of degenerative or post-traumatic origin, e.g. in the area of the intervertebral joints
In general, analgesic injections administered into the spine are a good method of reducing pain in the course of diseases and pathologies such as: sciatica, femur, spondylolisthesis (pathological displacement of one vertebra in relation to the other) and stenosis (narrowing of the spinal canal).
Who is a spine blocker a good solution for?
By administering the steroid directly to the site that triggers the pain in the spine, strong painkillers for the spine taken orally can be dispensed with. This saves the digestive system and the liver, especially in people taking other types of drugs in parallel.
Patients waiting for spine surgery with very severe back pain can obtain the desired relief from ailments thanks to the use of a blockade. Injecting the spine with corticosteroids is also a good solution for people who do not want or cannot undergo surgery due to comorbidities. In addition, blockage may benefit people who are overweight, whose condition can be treated with exercise, but due to back pain, certain activities aimed at reducing body weight and improving the condition of the spine are difficult to perform.
Types of spine blockages
Central intra-lamellar injection
The steroid is administered interlaminarly to the spinal canal, i.e. between the laminae of the arches of adjacent vertebrae. This type of blockade is of particular use in relieving the pain associated with spinal stenosis.
Side hole injection
The steroid drug is administered to the area of the intervertebral foramen through which the irritated nerve root runs. The blockade inhibits pain caused, for example, by a root-disc conflict in the course of sciatica or femoral,
Administration of a blockage to the sacroiliac joint
The painkiller is administered into the joint that connects the hip bone with the sacrum. The blockade is designed to reduce lower back pain (low back pain).
How is the steroid block administered to the spine?
The procedure takes about 30-45 minutes, is performed on an outpatient basis and does not require special preparation from the patient. Before administering the blockade, the doctor makes sure that there are no contraindications for the procedure. In order for the drug to be precisely administered to the diseased area, the spine injection is performed under X-ray control. During the procedure, the patient may feel a slight needle prick and a feeling of distraction when injecting the preparation. A few minutes after the injection into the spine, the anesthetic starts to work and its effect lasts for several hours - during this period, back pain may disappear completely. Pain may return after a few hours, and this is normal as the anti-inflammatory effects of the steroid drug only appear between the 3rd and 10th day after the blockade and the lumbar spine pain is properly treated. The effect of the blockade usually lasts for several weeks, although in some cases it may last up to a year.
It should be taken into account that in some cases a single injection of the lumbar spine may not be sufficient to completely eliminate the pain. On the other hand, it is not recommended to administer steroids more than 3-5 times a year. The doctor decides how often the blockages are administered.
After the spine injection with steroids, side effects may occur in the form of a short-term weakening of the motor functions of the lower limbs, which is associated with anesthesia of the nerve roots. In addition, it may cause a temporary increase in blood sugar, increase in blood pressure and increase in heart rate. In healthy people, side effects do not require treatment, but it is recommended that at least one day after surgery, the patient should lead a resting lifestyle.
Contraindications to the blockage of the spine
A contraindication to the administration of a steroid block is the presence of chronic diseases such as: severe peptic ulcer disease, unregulated arterial hypertension and unregulated diabetes. This is because minimal corticosteroid may enter the bloodstream during an injection, affecting cardiovascular function and glycemic control. Therefore, spine blockade is not performed in people who are allergic to any component of the drug. Bacterial skin infections at the injection site also exclude the patient from treatment with the blockade, as this could lead to the infection spreading to the spine and central nervous system. In addition, contraindications to X-ray irradiation, e.g. pregnancy, should be taken into account.
Other treatments for back pain
It is worth remembering that blockage is one of the treatment options for lumbar spine pain and low back pain. Reducing pain does not release the patient from participation in rehabilitation, the aim of which will be to prevent pain recurrence after the blockade ceases to work. For this purpose, a physiotherapist uses safe manual therapy techniques and teaches special exercises to counteract back pain. For example, exercises for back pain in the course of sciatica are designed to improve the activation of the muscles responsible for the active stabilization of the spine.
Other treatments for lumbar spine pain include:
Nerve blocks with the use of low temperature (cryolysis) or high-frequency current (thermolesion) - these are modern minimally invasive methods of combating persistent back pain without the need for pharmacological agents,
Surgical procedure - the operation may involve stabilization of the spine or discectomy, i.e. excision of a fragment of the intervertebral disc remaining in a mechanical conflict with the nerve root. Surgical treatment is the last resort when other attempts to treat back pain remain ineffective or when the spine has irreversible damage.
Important information
| Duration of the procedure (depending on the method) | 10 minutes |
| Tests required for surgery | lack |
| Anesthesia | topical skin |
| Hospital stay | 30minutes |
| A period of significant dysfunction | 8 hours |
| A period of limited dysfunction | - |
| Removal of stitches - first visit | - |
| Change of dressings | - |
| Contraindications to the procedure | purulent changes in the lumbar region |
Frequently asked questions about spine steroid block:
A blockage of the spine involves injecting the spine with a strong anti-inflammatory drug - a steroid, thanks to which the pain in the spine is reduced or eliminated. The procedure is performed under the control of fluoroscopy (X-ray view) in an outpatient setting.
The first analgesic effect that appears a few hours after the injection is due to the anesthetic drug given together with the steroid. The proper analgesic effect of Diprophos begins on the 3-7th day after the injection and lasts for several weeks (usually 4 weeks). If necessary, the blockade can be repeated, but there should be no more than 3-5 spine injections a year. Some patients, after blockage, function without back pain for a longer period of time and do not even need additional injections.
The spine injection procedure called a steroid blockade is an effective method of treating sciatica pain. The ingredient in the injectable drug is a steroid that works by inhibiting the inflammatory response responsible for pain. There are many preparations available on the market that are used for spine injections, such as Diprophos or Depo-Medrol.
Back pain can be treated both by an orthopedist specializing in the treatment of the spine and by a neurosurgeon. After collecting a detailed history, examination of the spine and analysis of imaging tests, the doctor should suggest the optimal methods of conservative or surgical treatment. The choice of treatment depends on the severity of the disease, the level of severity of back pain, the attempts to treat the spine so far and the presence of comorbidities in the patient. Conservative treatment can be carried out by an orthopedist with the active participation of a physiotherapist. If an invasive procedure (e.g. spine blockade) or surgery is required, treatment should be carried out by an experienced neurosurgeon.
