Lower back, neck, joint, and nerve pain can be debilitating—interfering with work, sleep, and daily activities. Pain management injections deliver medication directly to the source of discomfort, providing rapid, precise relief that oral medications often cannot match. At Maywell Health, our specialists offer a full spectrum of injection-based treatments tailored to each patient’s condition and goals.
In this article, we’ll cover:
- Understanding the basics of pain management injections
- Key benefits and mechanisms of action
- An overview of the most common injection types
- How to choose the right option for your needs
Let’s begin by exploring what pain management injections are and why they’re so effective.
Understanding Pain Management Injections
Pain management injections are interventional procedures that deliver anti-inflammatory and/or anesthetic medications directly into or around painful structures—such as joints, nerve roots, or soft tissues. By targeting the exact source of pain, these injections can:
- Reduce inflammation and swelling
- Interrupt pain signals before they reach the brain
- Improve mobility and function
- Provide immediate relief, often within hours
Most injections use corticosteroids (to calm inflammation) and local anesthetics (to numb pain). Some newer techniques, like regenerative therapy injections, harness your own growth factors to promote long-term healing. In each case, precision imaging (usually fluoroscopy or ultrasound) ensures the medication reaches its intended target safely and accurately.
These injections are typically one component of a comprehensive pain management plan, which may also include physical therapy, medications, and lifestyle modifications. Next, we’ll look at the specific types of injections offered at Maywell Health.
Key Benefits of Pain Management Injections
Pain management injections offer several advantages over systemic treatments by delivering medication directly to the source of your discomfort.
- Minimally Invasive—Most injections are performed on an outpatient basis with only a small needle puncture, reducing risks and recovery time compared to surgery.
- Rapid Symptom Relief—Many patients notice significant pain reduction within hours, allowing earlier participation in rehabilitation.
- Targeted Treatment—Injections can be precisely placed into joints, around nerves, or into soft tissue to address the exact source of pain.
- Reduced Inflammation—Corticosteroid components calm swollen tissues and nerve roots, interrupting the pain cycle.
- Long-Term Effects—Procedures such as radiofrequency ablation (RFA) and regenerative therapy injections (RIT) can provide relief lasting months to years by disrupting pain pathways or promoting tissue healing.
These benefits make injections a powerful tool within a holistic, multimodal pain management plan.
How Pain Management Injections Work
Pain management injections deliver medications directly to the area causing your discomfort. This targeted approach ensures maximum effect with minimal systemic exposure.
Delivery Mechanism
A fine needle is guided—under fluoroscopy (real-time X-ray) or ultrasound—to the precise location: a joint space, nerve root, epidural area, or soft tissue.
Medications Used
- Corticosteroids (e.g., methylprednisolone): Reduce inflammation around nerves and joints.
- Local Anesthetics (e.g., lidocaine): Provide immediate numbing of pain signals.
- Regenerative Agents (e.g., platelet-rich plasma): Harness growth factors to promote tissue repair.
Duration of Relief
- Short-Term Relief: Local anesthetics can provide pain relief lasting hours to days.
- Intermediate Relief: Steroid injections typically last several weeks to months.
- Long-Term Relief: Treatments like RFA or regenerative therapy can extend relief to six months or longer by altering pain pathways or facilitating healing.
By understanding how these injections function, you can better appreciate their role within a broader, personalized pain management strategy.
Exploring Different Types of Pain Management Injections
Pain management injections differ in their targets, techniques, and duration of relief. At Maywell Health, we offer a comprehensive range of these minimally invasive therapies, including:
- Epidural Steroid Injections (ESI)
- Nerve Blocks
- Selective Nerve Root Blocks (SNRB)
- Facet Joint Injections
- Sacroiliac Joint Injections
- Medial Branch Blocks
- Radiofrequency Ablation (RFA)
- Regenerative Therapy Injections (RIT)
Each modality is selected to address your specific pain source—whether it’s a compressed nerve root, inflamed joint, or degenerative tissue. In the next section, we’ll dive into the details of Epidural Steroid Injections (ESI).
1. Epidural Steroid Injections (ESI)
Epidural Steroid Injections deliver a combination of corticosteroid and anesthetic into the epidural space surrounding the spinal cord and nerve roots. This treatment is ideal for conditions such as herniated discs, spinal stenosis, and sciatica.
Procedure:
The patient lies prone on an X-ray table. After numbing the skin, the physician uses fluoroscopic guidance to advance a thin needle into the epidural space. Contrast dye may be injected to confirm proper placement before administering the medication.
Expected Outcomes:
- Reduced Inflammation: Steroid component calms swollen nerve roots.
- Improved Mobility: Patients often experience relief within 24–48 hours, allowing them to engage more effectively in physical therapy.
- Duration of Relief: Many report significant symptom reduction lasting from several weeks up to six months.
Safety and Considerations:
- Mild soreness at the injection site is common.
- Multiple injections (up to three per year) may be scheduled based on patient response and clinical guidelines.
- Not suitable for individuals with certain infections, bleeding disorders, or uncontrolled diabetes.
Epidural Steroid Injections offer both diagnostic insight—confirming the source of nerve-related pain—and therapeutic relief, making them a cornerstone of interventional pain management.
2. Nerve Blocks
Nerve blocks involve injecting an anesthetic—and sometimes a steroid—directly around specific nerves to interrupt pain signaling. They are used for a variety of acute and chronic pain conditions, including complex regional pain syndrome (CRPS), trigeminal neuralgia, and post-surgical pain.
Types of Nerve Blocks:
- Sympathetic Nerve Blocks: Target the sympathetic chain to relieve autonomic pain syndromes such as CRPS or chronic abdominal pain.
- Peripheral Nerve Blocks: Delivered near peripheral nerves (e.g., sciatic, femoral, or brachial plexus) to manage localized pain in the legs, arms, or face.
Procedure:
Under ultrasound or fluoroscopic guidance, the physician advances a fine needle adjacent to the targeted nerve. After confirming placement, the anesthetic (and steroid, if used) is slowly injected.
Expected Outcomes:
- Immediate Pain Relief: Anesthetic provides prompt numbing.
- Diagnostic Value: Relief confirms the nerve’s role in the pain syndrome.
- Duration of Relief: Depending on medications used, relief can last from hours (anesthetic alone) to several weeks (with steroid).
Safety and Considerations:
- Monitor for temporary numbness or weakness in the targeted area.
- Multiple blocks may be performed to optimize outcomes.
- Not recommended for patients with local infection, bleeding disorders, or allergy to injectables.
Nerve blocks are versatile tools that both diagnose and treat nerve-mediated pain, often serving as a bridge to other longer-term therapies.
3. Selective Nerve Root Blocks (SNRB)
Selective Nerve Root Blocks target specific spinal nerve roots responsible for radicular pain, such as sciatica or cervical radiculopathy. By anesthetizing the implicated nerve root, SNRBs help both diagnose and treat nerve root–related pain.
Purpose of SNRBs:
- Pinpoint the exact nerve root causing pain.
- Provide targeted relief to confirm diagnosis and guide further treatment.
Procedure:
The patient lies on their side or stomach. Under fluoroscopic guidance, a needle is positioned adjacent to the suspected nerve root. Contrast dye may be injected to verify placement. Then, a small amount of anesthetic—with or without steroid—is administered.
Expected Outcomes:
- Immediate Diagnostic Clarity: Temporary pain relief confirms the targeted nerve root.
- Reduced Inflammation: Steroid may lessen nerve swelling, extending relief for weeks to months.
- Improved Function: By confirming the pain source, SNRBs facilitate precise planning for further interventions like RFA.
Safety and Considerations:
- Brief discomfort during injection is common.
- Repeat blocks may be scheduled based on diagnostic needs and patient response.
- Not suitable for patients with contrast allergies, active infections, or certain bleeding risks.
Selective Nerve Root Blocks are invaluable for accurately identifying and treating spinal nerve–derived pain, ensuring patients receive the most effective subsequent interventions.
4. Facet Joint Injections
Facet joint injections deliver anesthetic and steroid directly into the small joints between vertebrae to reduce inflammation and alleviate back or neck pain caused by arthritis or degeneration.
Procedure:
The patient lies prone on an X-ray table. After numbing the skin, the physician uses fluoroscopic guidance to insert a needle into the facet joint space. Contrast dye confirms accurate placement before the medication is injected.
Expected Outcomes:
- Immediate Pain Reduction: Local anesthetic offers prompt relief.
- Extended Symptom Control: Corticosteroid component reduces joint inflammation, with benefits lasting several weeks to months.
- Improved Mobility: Patients often notice easier movement and less stiffness.
Safety and Considerations:
- Mild soreness at the injection site is typical.
- Limited to a few injections per year per joint to avoid steroid overuse.
- Not recommended for those with infection at the injection site or systemic infection.
Facet joint injections are an effective option for patients whose pain originates from joint degeneration, providing both diagnostic insight and tangible relief.
5. Sacroiliac Joint Injections
Sacroiliac (SI) joint injections target the joint linking the spine to the pelvis, often a source of lower back and buttock pain when inflamed or dysfunctional.
Procedure:
The patient lies on their side. Using fluoroscopic or ultrasound guidance, the physician directs a needle into the SI joint. Contrast dye may be used to verify placement before injecting a mixture of anesthetic and steroid.
Expected Outcomes:
- Rapid Pain Relief: Local anesthetic provides immediate numbing.
- Reduced Joint Inflammation: Steroid lowers inflammation, with effects lasting weeks to months.
- Improved Daily Function: Patients frequently report easier sitting, standing, and walking.
Safety and Considerations:
- Temporary soreness at the injection site is common.
- Injection frequency is typically limited to avoid steroid-related side effects.
- Not suitable for active infections or uncorrected bleeding disorders.
SI joint injections offer targeted relief for patients suffering from pelvic and lower back discomfort, helping restore mobility and quality of life.
6. Medial Branch Blocks
Medial branch blocks involve injecting anesthetic near the small nerves that innervate the facet joints, disrupting pain signals from these joints to the brain.
Procedure:
With the patient prone, the physician uses fluoroscopic guidance to position needles adjacent to the medial branch nerves. After confirming location with contrast dye, an anesthetic (and sometimes steroid) is injected.
Expected Outcomes:
- Immediate Pain Interruption: Anesthetic halts pain transmission, providing quick relief.
- Diagnostic Clarity: Relief confirms facet joints as the pain source.
- Short- to Intermediate-Term Relief: Steroid may extend relief for weeks.
Safety and Considerations:
- Mild post-injection soreness is normal.
- Multiple blocks may be performed to evaluate response before considering radiofrequency ablation.
- Contraindications include local infection or bleeding disorders.
By confirming facet joint–mediated pain, medial branch blocks guide targeted treatments like radiofrequency ablation for longer-lasting relief.
7. Radiofrequency Ablation (RFA)
Radiofrequency Ablation uses heat generated by radio waves to disable specific nerves that transmit pain signals, offering longer-lasting relief than diagnostic blocks.
Procedure:
The patient lies prone and the physician guides a RF probe next to the target nerve using fluoroscopy. After test stimulation to confirm correct placement, radiofrequency energy is applied for 60–90 seconds to create a small lesion that disrupts nerve function.
Expected Outcomes:
- Extended Relief: Pain reduction often lasts six months to over a year.
- Improved Function: Patients report better mobility and reduced reliance on medications.
- Minimal Downtime: Most return to normal activities within a day.
Safety and Considerations:
- Temporary numbness or tingling may occur.
- Repeat procedures can be performed as nerve function regenerates.
- Not recommended for patients with implanted electronic devices or active infections.
RFA is ideal for chronic facet joint or sacroiliac joint–mediated pain, providing a durable, minimally invasive solution.
8. Regenerative Therapy Injections (RIT)
Regenerative Therapy Injections use the body’s own healing mechanisms to repair damaged tissues. Common modalities include Platelet-Rich Plasma (PRP) and stem cell–based treatments.
Procedure:
- PRP: A blood sample is drawn and centrifuged to concentrate platelets. Under ultrasound guidance, the PRP is injected into the injured area (e.g., tendon, ligament, joint).
- Stem Cells: Cells are harvested from bone marrow or adipose tissue, processed, and injected into the target site to promote tissue regeneration.
Expected Outcomes:
- Tissue Healing: Growth factors stimulate cell repair and regeneration.
- Reduced Inflammation: Natural cytokines help calm chronic inflammation.
- Gradual, Lasting Relief: Improvement often occurs over weeks to months as tissue heals.
Safety and Considerations:
- Mild soreness and swelling at the injection site are common.
- Multiple sessions may be needed for optimal results.
- RIT is not covered by all insurance plans and may require out-of-pocket costs.
Benefits and Considerations When Choosing Pain Management Injections
- Minimally Invasive: Outpatient procedures with needle-based access reduce surgical risk.
- Rapid Symptom Relief: Many injections provide relief within hours to days.
- Targeted Treatment: Precision imaging ensures medication reaches the exact pain source.
- Reduced Inflammation: Corticosteroids and growth factors calm painful tissues.
- Long-Term Effects: Techniques like RFA and RIT offer relief lasting months to years.
Considerations:
- Individualized Assessment: Not every injection suits every patient; selection depends on diagnosis, medical history, and goals.
- Qualified Specialists: Outcomes hinge on the physician’s expertise and imaging accuracy.
- Comprehensive Plan: Injections work best when paired with rehabilitation, medications, and lifestyle changes.
Frequently Asked Questions (FAQ)
What are pain management injections?
They are minimally invasive procedures that deliver medication—such as corticosteroids, anesthetics, or regenerative agents—directly to painful areas to reduce inflammation and interrupt pain signals.
How do epidural steroid injections work?
Epidural injections deliver corticosteroid and anesthetic into the epidural space around the spinal cord, reducing nerve inflammation and providing relief for conditions like sciatica and spinal stenosis.
What is the purpose of nerve blocks?
Nerve blocks inject anesthetic (and optional steroid) near specific nerves to halt pain signal transmission, aiding both diagnosis and short-term relief for neuropathic or acute postoperative pain.
What are selective nerve root blocks used for?
They pinpoint and treat pain originating from individual spinal nerve roots—helping diagnose radiculopathy and guide further treatments such as radiofrequency ablation.
How do facet joint injections help with arthritis-related back pain?
By injecting anesthetic and steroid directly into inflamed facet joints, these injections reduce joint swelling, alleviate pain, and improve spinal mobility.
What is radiofrequency ablation and how does it differ from other injection methods?
RFA uses radio waves to create heat lesions on pain-transmitting nerves, offering longer-lasting relief (six months to over a year) compared to steroid or anesthetic blocks that typically last weeks to months.
