Best Practice Recommendations for Use of Spinal Injections

Researchers from the Centre for Spinal Surgery in Zurich, Switzerland offer doctors a review of the role and use of spinal injections. This includes discography, facet joint blocks, nerve root blocks, and epidural injections.

The authors conduct a review of studies done in these areas. They also offer their own opinions based on data from their cases. They say that studies don't really support the use of spinal injections. The cost is far greater than the benefit patients get.

Until further studies can sort this all out, they make a few suggestions. First, discography should be used only for patients who would have surgery if they could find the exact disc that's the problem. It shouldn't be used just to confirm there's a disc problem.

Second, injections into the spinal (facet) joints are best for older adults with joint osteoarthritis who don't want to have surgery. Third, nerve root blocks should be tried before surgery for nerve root pain. In many cases the patient gets pain relief right away that last a long time.

Finally, epidural injections into the spinal canal are best used when there's pressure on the spinal cord or on multiple nerve roots. Epidural injections don't seem to work as well as single nerve root injections.

This review on the state-of-the-art injection methods for spinal problems gives doctors best practice guidelines. It’s based on current scientific studies and articles published.