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“I would like to thank all the doctor’s assistants and nurses at IPPMC. They have helped me out the most of any different medical places I have been for my pain. They have done the best job explaining and treating my pain after a 19 year period. The best place I ever went for my pain management. I would suggest anybody come here and try it if you are dealing with pain. Thank you IPPMC.”
— Mark

What are spinal injections?

 In many cases of chronic back pain, spinal injections are used both to learn more about what is causing your pain and to treat your pain. Health care providers refer to these two separate uses of spinal injections as diagnostic and therapeutic. The injections can be a diagnostic tool because they give your doctor information that helps him or her make a diagnosis. For example, if an injection provides pain relief in the area that is injected, it is likely that this particular area is the source of the problem. Once the location of one or more sources of pain is discovered, your health care provider can perform other necessary tests to try to determine the actual problem and create the proper treatment plan. The injections are therapeutic in that they can provide temporary treatment and temporary relief from pain.


What Medications Are Injected and why?

 With most spinal injections, a local anesthetic (numbing medication) called lidocaine (also known as Xylocaine) is injected into a specific area of the spine. Lidocaine is a fast-acting drug, but the effects wear off within about two hours. Therefore, this medication is used more as a diagnostic tool than a long-lasting pain reliever. Another type of anesthetic, called Bupivacaine (also known as Marcaine), can also be used. This anesthetic takes longer to take effect, but it also wears off slower, giving the patient more relief from pain.

 A strong anti-inflammatory steroid medication, cortisone, is also commonly injected along with one of the above anesthetics in order to reduce inflammation in the affected areas. Cortisone is long lasting and can be slow releasing in order to give the best possible benefits of pain relief. Cortisone may take several days to begin working to reduce inflammation following injection, but the effects can last for months.


What can I expect during the procedure?

 The procedure is usually brief, but your position during the procedure is important to make the injection go smoothly, with the least discomfort to you. You may have monitoring devices attached to you during the procedure to check your heart rate and breathing.

  • Your skin will be cleaned with a sterilizing solution and a sterile drape will be placed over your skin.
  • Conscious sedation (use of a calming drug while you are awake) may be used if your doctor feels it is appropriate.
  • Local anesthetic (lidocaine) is usually given near the injection site to numb the skin. This typically feels like a pin prick and some burning, like a bee sting.
  • Fluoroscopy (X-ray imaging) is often used for precise placement of the injection. Contrast dye may be injected to confirm the correct placement of the needle.
  • A local anesthetic for numbing (eg, lidocaine, bupivicaine) and/or steroids (to reduce inflammation) is injected.
  • A small bandage may be placed at the injection site.


What should I expect after the procedure?

  • After some injections, you may spend time in a recovery area after the procedure.
  • You may be monitored to make sure you are doing well and your vital signs may be checked.
  • You may be asked to fill out paper work before leaving.
  • You usually should have someone drive you home.
  • You may put ice packs on the injection site for 10-20 minutes at a time if there is soreness. Be careful not to burn your skin with the ice - place a towel between the ice and your skin.
  • You may take a shower but avoid baths, pools or whirlpools for 24-48 hours following the procedure.
  • You may be asked to relax on the day of injection, but usually can resume normal daily activities the day after the injection.
  • You usually can start or resume your individualized exercise program or physical therapy program within 1 week of your injection.
  • Side effects which may occur but go away in a few days include Briefly increased pain, Headaches, Trouble sleeping, Facial flushing & Hiccups.

It takes a few days, even a week or longer, for the steroid medicine to reduce inflammation and pain. Your doctor may want to follow-up with you in 1-3 weeks.


If you had sedation, you probably should not drive for 24 hours after the procedure.


Adapted from

Abott Northwestern Hospital
800 East 28th Street,
Minneapolis, MN 55407
North Memorial Medical Center
3300 Oakdale Avenue North,
Robbinsdale, MN 55422
2301 Connecticut Avenue South,
Sartell, MN 56377
Office: 320-229-1500
Toll Free: 1-888-414-PAIN
Fax: 320-229-1505