Chronic pain can take a toll on your physical health, emotional well-being, and quality of life. For many patients, injection therapies offer an effective way to manage pain, reduce inflammation, and restore function—without the need for invasive surgery. From facet joint injections to epidural steroid injections, these procedures target pain at its source and provide significant relief for a range of conditions.
In this deep-dive, we’ll explore the different types of injection therapies, how they work, and which patients may benefit from them.
Understanding Injection Therapy
Injection therapy involves administering medication directly into specific areas of the body to relieve pain and inflammation. These treatments are typically performed under image guidance—such as fluoroscopy (X-ray) or ultrasound—to ensure precision and safety.
Most injections are outpatient procedures, meaning patients can return home the same day. They are commonly used for:
- Chronic back or neck pain
- Herniated discs
- Spinal stenosis
- Facet joint arthritis
- Sciatica
- Joint pain (shoulder, hip, or knee)
While injections are not a cure for underlying conditions, they can provide weeks or even months of relief, giving patients the ability to participate in physical therapy and daily activities more comfortably.
Facet Joint Injections: Targeting Spinal Joint Pain
What Are Facet Joints?
Facet joints are small stabilizing joints located between and behind adjacent vertebrae in the spine. These joints allow for flexibility and movement but can become inflamed due to arthritis, injury, or wear-and-tear over time.
How Facet Joint Injections Work
A facet joint injection delivers a mixture of a local anesthetic and a corticosteroid directly into the joint capsule. The anesthetic provides immediate pain relief, while the steroid reduces inflammation for longer-lasting effects.
These injections serve two purposes:
- Diagnostic – To confirm whether facet joints are the source of pain.
- Therapeutic – To provide pain relief and reduce inflammation.
Ideal Candidates
Patients with facet joint syndrome or arthritis-related back and neck pain are often good candidates. If facet joint injections provide temporary relief, physicians may recommend a follow-up procedure called radiofrequency ablation, which can provide longer-term pain relief by disrupting the nerves transmitting pain signals.
Epidural Steroid Injections: Relief for Nerve Root Pain
What Is an Epidural Space?
The epidural space is the area around the spinal cord where nerve roots exit to travel throughout the body. When these nerve roots become irritated—due to herniated discs, spinal stenosis, or bone spurs—it can cause radiating pain, numbness, or weakness in the arms or legs.
How Epidural Steroid Injections Work
Epidural steroid injections (ESIs) deliver anti-inflammatory medication directly into the epidural space. The corticosteroid calms inflamed nerves and reduces swelling, which in turn decreases pain and improves mobility.
ESIs are especially effective for conditions like:
- Sciatica (pain radiating down the leg)
- Cervical radiculopathy (radiating arm pain)
- Herniated discs
- Degenerative disc disease
Approaches to Epidural Injections
There are three main techniques for administering epidural injections:
- Interlaminar – Medication is injected between two vertebrae, spreading over several spinal levels.
- Transforaminal – Targets the specific nerve root causing pain.
- Caudal – Delivered through the sacral hiatus at the base of the spine, often used for lower back pain.
Ideal Candidates
Patients with nerve root compression and radiating pain that hasn’t responded to conservative treatments—like medications and physical therapy—may benefit from ESIs.
Sacroiliac Joint Injections: Addressing Lower Back & Pelvic Pain
What Is the Sacroiliac (SI) Joint?
The SI joint connects the base of the spine (sacrum) to the pelvis. Dysfunction or inflammation in this joint can cause pain in the lower back, buttocks, and even down the legs.
How SI Joint Injections Work
An SI joint injection delivers corticosteroids and anesthetics directly into the joint to reduce pain and inflammation. Like facet joint injections, these can be diagnostic and therapeutic.
Ideal Candidates
Patients with SI joint dysfunction often describe pain worsening with standing, walking, or climbing stairs. SI joint injections can help confirm the diagnosis and provide relief.
Trigger Point Injections: Targeting Muscle Pain
What Are Trigger Points?
Trigger points are tight “knots” in muscles that can cause localized or referred pain. These sensitive areas are common in patients with myofascial pain syndrome or chronic muscle tension.
How Trigger Point Injections Work
A trigger point injection (TPI) involves inserting a small needle into the trigger point and injecting a local anesthetic, sometimes combined with a steroid. The procedure inactivates the trigger point and alleviates pain.
Ideal Candidates
Patients with chronic muscle pain or tension that does not respond to massage or physical therapy may benefit from TPIs.
What to Expect During and After Injection Therapy
During the Procedure
- Most injections take 15–30 minutes.
- Imaging guidance ensures accuracy.
- You may feel mild pressure or discomfort during the injection.
After the Procedure
- Temporary soreness at the injection site is common.
- Pain relief may be immediate (from the anesthetic) or gradual (as the steroid takes effect over several days).
- You may be advised to avoid strenuous activities for 24–48 hours.
Risks and Side Effects
Injection therapy is generally safe, but potential risks include:
- Mild pain or bruising at the injection site
- Temporary increase in pain (a “steroid flare”)
- Rare complications like infection or nerve injury
Your physician will discuss the benefits and risks to help you make an informed decision.
The Role of Injection Therapy in Comprehensive Pain Management
While injection therapy provides valuable pain relief, it works best as part of a multidisciplinary approach. Combining injections with physical therapy, exercise, and lifestyle modifications can address underlying causes and support long-term recovery.
In some cases, injections may allow patients to delay or avoid surgery altogether. For others, they provide enough relief to resume activities that improve strength and flexibility.
Is Injection Therapy Right for You?
If chronic pain is limiting your life and conservative treatments haven’t worked, injection therapy may be a worthwhile option. A pain management specialist can evaluate your symptoms, perform diagnostic imaging, and recommend the most appropriate type of injection for your condition.
By targeting the source of pain directly, injection therapies like facet joint injections, epidural steroid injections, and trigger point injections offer a minimally invasive path to relief and improved quality of life.
Final Thoughts
Injection therapy has transformed the way chronic pain is managed, providing targeted, fast-acting relief for countless patients. Whether you’re struggling with back pain, nerve irritation, or muscle tension, there’s likely an injection option to help you regain control and get back to the activities you love.
Always consult with your physician or a pain management specialist to explore your options and create a treatment plan tailored to your needs.
