Spinal Injections

This information will help you prepare for your spinal injection (shot) at Memorial Sloan Kettering (MSK).

Spinal Injections

Spinal injections are used to treat irritation, inflammation, and pain in your spine. They can help treat certain symptoms, such as:

  • Neck, back, or leg pain
  • Tingling
  • Numbness or weakness that starts in the lower back and travels through the buttocks and down the large nerve in the back of the leg

These symptoms may be caused by:

  • A herniated disc, or a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine.
  • Arthritis (inflammation of your joints).
  • Spinal stenosis (narrowing of 1 or more areas in your spine).
  • Injury to your spine.

Spinal injections can be made up of steroids, numbing medications, or both. Steroids help to decrease nerve inflammation and discomfort. Numbing medication (lidocaine) can be used to block the feeling of pain for a short period of time.

Types of spinal injections

There are 4 sections of your spine. Figure 1 shows the sections and the different types of injections that you may get. Your doctor will decide which type of injection will be best to help with your discomfort.

Types of spinal injections include:

  • Epidural injection in your epidural space. The epidural space goes from the base of your head to part of the spine that is below your hips. The nerves in your back are in this space. A steroid and numbing medication can be injected into any part of the epidural space.
  • Facet injection into your facet joint. The facet joint is where each vertebra connects to the next. Sometimes, arthritis can develop in the facet joints and cause pain. An anti-inflammatory steroid and numbing medication can be injected directly into the facet joints to decrease pain.
  • Medial branch block around your medial branch nerves. Medial branch nerves are very small nerves that control feeling in your facet joints. Numbing medication can be injected around the nerve(s) to decrease the pain in the joints.
Figure 1. Types of spinal injections
 
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Before Your Procedure

Tell your doctor:

  • About any medical conditions you have.
  • If you currently have or have recently had an infection.
  • If you’re currently receiving chemotherapy or radiation therapy.
  • If you think that you may be pregnant.
  • If you’re allergic to any medications, especially to iodine, contrast, lidocaine, or any antibiotics.
  • If you’re allergic to latex.
  • If you have any implants in your body (such as pacemakers, Mediport®, joint replacement, stents, shunts, breast implants, or orthopedic hardware).
  • If you have ever been instructed to take antibiotics before a dental procedure or surgery.
  • If you’re experiencing chest pain or trouble breathing.
  • All the prescription medications (medications prescribed by a doctor) you’re taking.
  • All the over-the-counter medications (medications I buy without a prescription) you’re taking.
  • All the dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.

Ask about your medications

You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications are safe for you to stop taking. We have included some common examples below.

  • If you take medication to thin your blood, ask the doctor who prescribes it for you when to stop taking it. Some examples are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®).
  • Please review the information in the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs). It includes important information about medications you’ll need to avoid before your procedure and what medications you can take instead.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. If you don’t have someone to do this, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.

Agencies in New York                                         Agencies in New Jersey
Partners in Care: 888-735-8913                                         Caring People: 877-227-4649
Caring People: 877-227-4649                                          

 

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The Day of Your Procedure

Things to remember

  • You can have a light breakfast on the morning of your injection.
  • If you take daily medication, we will tell you which ones to take on the morning of your injection.

MSK's parking garage

Where to park

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.

To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital.

There are also other garages located on East 69th Street between First and Second Avenues, East 67thStreet between York and First Avenues, and East 65thStreet between First and Second Avenues.

Where to go

You will have your procedure at 444 East 68th Street between First and York Avenues. This is a side entrance of the main MSK building. Take the H elevators to the 3rd floor and go to room A341.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

You will change into a hospital gown and remove all necklaces, chains, and earrings. Your temperature, blood pressure, heart rate, and breathing rate will be checked. You may need to have blood tests before your injection if you have been taking blood thinners, have had chemotherapy within the last month, or think that you may be pregnant. Your pain doctor will speak with you to review the procedure and answer your questions. If you haven’t signed a consent form, you will sign one then.

You will be helped onto the x-ray table and helped to lie on your abdomen (belly) or your side, depending on the site of your injection. Using a fluoroscopy (a type of real-time x-ray) your doctor will find the location for your injection. You will be given medication to numb your skin. Your doctor will then insert a thin needle into the injection site.

Before injecting the medication, your doctor will inject a dye to check the position of the needle. They will use fluoroscopy to make sure that the needle is in the right place and then will inject the steroid, numbing medication (lidocaine), or both. The needle will be removed and a bandage will be placed over the injection site.

After your injection, your nurse will examine you and check your blood pressure, heart rate, breathing rate, and temperature.

The procedure takes about 45 minutes.

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After Your Injection

Caring for yourself at home

  • Keep the bandage on your injection site until the morning after your injection. You can then remove it and take a shower.
  • Don’t take a tub bath, soak in water, or swim for 24 hours after your injection.
  • If your injection site is sore, you can apply a cold pack to the area. Apply it 15 minutes on and 15 minutes off for 24 hours.
  • Don’t put heat on or near the injection site for 24 hours.
  • If you have diabetes, you will need to monitor your blood sugar after the injection. Steroids can temporarily cause blood sugar to rise.
  • Avoid strenuous physical activity and exercise, such as lifting weights or running, for 1 week after your injection.
  • If you stopped taking any medication before your injection, ask your doctor when you can start taking it again.
  • It may take up to 1 week before you feel the full benefit of the medication. In the meantime, you can take ________________ if you have any discomfort in your spine.
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Call Your Doctor if You Have:

  • A temperature of 100.4° F (38.0° C) or higher
  • Changes in your vision
  • Dizziness
  • Changes in your bowel or bladder functioning, such as not being able to control your bowels or bladder
  • Increased drowsiness
  • A severe headache that doesn’t go away with medication
  • Any new or increasing pain, numbness, tingling, or weakness anywhere on your body
  • Any redness, swelling, drainage, or bleeding at the injection site
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