Back injections can provide significant pain relief for some people. Doctors target specific locations in your spine and muscle to provide the most effective pain relief.

If you have back pain that’s not responding to typical treatments, a doctor or healthcare professional might recommend an injection. There are different types of injections, but most involve cortisone. Cortisone is a corticosteroid medication that helps reduce inflammation in targeted areas like your spinal disks, joints, and tendons.

Other common back injections include trigger point injections, which target spasming muscles, and nerve blocks. An injection into your back can relieve pain quickly, but the effects are usually temporary.

Spinal injections are used to both diagnose and treat back pain. If you’re getting an injection for diagnostic reasons, it’s probably because a doctor is trying to identify the exact nerve or disk at the root of your pain. After identifying the source of your pain, a doctor can offer more targeted treatment options.

All procedures involve some risk, like pain or infection at the injection site.

Keep reading to learn more about the different types of injections, how they can help your back pain, and the risks involved.

If you’re experiencing nerve pain, such as a pinched nerve, a doctor may recommend a steroid (cortisone) injection into the epidural space around your spinal bones. This injection penetrates several layers of tissue and muscle to reach the epidural space between two vertebrae.

Epidural steroid injections usually include an anesthetic to help reduce the pain during your procedure. A doctor will use contrast dye and imaging techniques to ensure the cortisone goes exactly where it’s supposed to go. The location of your injection will depend on which nerve root is affected.

Epidural steroid injections may help relieve pain caused by spinal nerve problems, such as:

Epidural steroid injections can provide significant pain relief lasting anywhere from 1 week to 1 year. But they don’t “cure” your condition.

Side effects of cortisone

Most back injections involve cortisone, a corticosteroid. Side effects of cortisone can include:

  • temporarily increased blood sugar levels
  • facial flushing
  • temporarily elevated blood pressure levels
  • insomnia
  • increased appetite
  • adrenal insufficiency
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Risks and side effects

Epidural spinal injections rarely cause side effects. Rare but serious side effects include:

Talk with a doctor about your health history before an epidural steroid injection, especially if you have congestive heart failure or diabetes.

Facet joint injections are a commonly performed procedure for people with pain stemming from their facet joints. A facet joint is a joint between two vertebrae in your spine. When these joints are inflamed, they can cause pain in your back, neck, and legs.

Facet joint injections usually include a steroid like cortisone. The medication is injected directly into your joint. A doctor will use ultrasound imaging to make sure the medication is delivered to the correct location.

Facet joint injections may help back pain caused by:

Facet joint injections are also a good method for diagnosing the origin of certain types of back pain.

Pain in your sacroiliac (SI) joint is a common cause of low back pain. A doctor can inject medication (usually cortisone) directly into or around this joint to help relieve your symptoms. They’ll use imaging techniques to help guide the needle to the correct location.

SI joint injections can provide significant pain relief that lasts for several weeks or longer.

SI joint injections may help low back pain caused by:

Risks and side effects

Side effects of SI joint injection may include:

  • temporary difficulty bearing weight on your leg on the injected side
  • temporary menstrual cycle changes
  • leg numbness or weakness
  • infection
  • flushing

Talk with a doctor before the procedure if you have diabetes, because cortisone can affect your blood sugar levels.

Trigger points are tight “knots” in your muscles that are tender to the touch and cause pain that spreads to other areas, like your arms and legs.

Trigger point injections work with other therapies, such as muscle relaxants, to relieve tightness in tough or spasming muscles. Injections may contain cortisone, which temporarily relaxes your muscle, allowing more blood to reach the area. More blood flow promotes healing and allows your muscle to lengthen and stretch.

Injections may also contain an anesthetic, botulism toxin A (Botox), or a combination of medications. A doctor might also recommend dry needling, a procedure where no medication is injected into your muscle.

Trigger point injections can be effective, but the results are temporary. The effects can be prolonged with stretching exercises and other therapies.

Risks and side effects

Talk with a doctor before the procedure if any of the following are true:

  • You have severe fibromyalgia.
  • You have a history of keloid formation.
  • You have a psychiatric disorder that’s difficult to treat.

Radiofrequency ablation destroys tissue near or on nerve roots coming out of your spinal cord. This works to decrease or interrupt pain signals.

It may help chronic back or neck pain, including:

Research into the effectiveness of radiofrequency ablation is limited, but case studies and observational reports have shown favorable results. Depending on the type of radiofrequency treatment and pain location, there may be varying degrees of pain relief.

Risks and side effects

After radiofrequency ablation, you may feel a sunburn-like sensation in the area, which may be sensitive to touch. It could also feel numb.

Radiofrequency ablation is not recommended if you have increased pressure in your brain.

Nerve blocks stop the transmission of nerve impulses, which stops pain signals from reaching your brain. They’re commonly used in place of an anesthetic for procedures on your arms and legs. But they can also be used, with varying techniques, to treat chronic pain.

Doctors may recommend a nerve block in certain situations, such as to control pain in people with dementia or confusion. It’s also an option for people who don’t respond to or can’t tolerate oral pain medications.

Risks and side effects

You may have side effects such as:

  • numbness around your mouth and lips
  • a metallic taste in your mouth
  • peripheral nerve injury
  • high blood sugar
  • hearing changes
  • blurred vision
  • agitation
  • seizures

In some situations, you may have side effects that involve your heart:

  • Different injections are used to treat back pain, depending on the type and cause of your pain.
  • Injections containing steroids like cortisone are common. Pain relief can last from days to weeks.
  • There are risks associated with all procedures. Talk with a doctor about the risks versus benefits.