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What Is Pain Management?

If you suffer from spine pain or joint pain, there are many ways to manage it without surgery. One option involves injecting the affected site with medication. These procedures include cortisone shots, epidural steroid injections, and facet blocks. 

Why Is It Done?

These procedures deliver relief directly to the area of the body that is in pain. They are considered under the following conditions:

  • You have finished a round of medication or physical therapy.
  • You are trying to avoid surgery for as long as possible. 

A cortisone shot can help relieve pain and lessen inflammation. They can treat symptoms of bursitis, carpal tunnel syndrome, osteoarthritis, plantar fasciitis, rheumatoid arthritis, and tendonitis

An epidural steroid injection will reduce inflammation and can be helpful for spinal stenosis, herniated disc, and degenerative disc disease. Patients who have tumors or infections should avoid these injections. 

A facet block is used where two or more bones are joined. If pain is generating from a facet joint, a block can numb the pain. 

How to Prepare

Talk to your doctor about what form of pain management might work best for your specific symptoms and condition. Since these procedures are not surgical, they require less preparation than others. But be sure to ask your doctor about any precautions you should take. 

What to Expect

A cortisone shot will usually be administered in your doctor's office. The medication may be a combination of a corticosteroid and an anesthetic. After the shot, you should protect the affected site for a day or two and watch for any signs of infection. You may experience pain just after the procedure, but then pain and inflammation should markedly decrease. 

Before an epidural steroid injection, you will receive a local anesthetic to numb your lower back. The injection is made into the dura, which is home to the nerve roots that contain spinal fluid. About 50 percent of patients report pain relief from steroid injections, and the effects last from a week to a year.

During a facet block, your doctor will insert lidocaine or a steroid into the facet joint capsule. He or she will likely be guided by a fluoroscopy, which is a real-time x-ray. If the procedure helps alleviate your pain, it can be repeated-up to a total of three times a year.


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