Injections for chronic pain are generally done into a joint space, around specific nerves and sometimes into trigger points. The injection mixture usually contains a long acting local anaesthetic and a long acting steroid. These help by reducing some of the pain signals travelling to the brain. Even though it may not be a cure, the benefits can last for several weeks or months. Sometimes injections are used to help in getting a diagnosis and planning an appropriate surgery.
The pain relief from an injection procedure should be taken as a window of opportunity to engage with physiotherapy and undertake regular exercise to improve the long term outcome.
The decision on whether to go ahead for an injection procedure is an optional one. The likelihood of the injection being a successful treatment for you is best discussed in the clinic.
(a) You could decide not to have an injection at all and look at other conservative strategies to develop your pain coping skills.
(b) You could have an injection to help break your pain->activity->increased pain cycling. Thereafter, use a conservative strategy to manage your pain.
(c) You could decide to keep having these injections at safe periodic intervals, so long as you find them beneficial. You would be exposed to the possible long term risks of repeated steroid injections.
What to expect during procedure
You will be positioned as required for the injection procedure. This may be done under X-ray or Ultrasound guidance. The skin area is cleaned using an antiseptic solution. Local anaesthetic is introduced through a very fine needle to minimise discomfort. This may feel warm, tingly or sting for a few moments before the area goes numb. An injection needle is then guided into the target point and the drug mixture injected slowly. You may feel pressure, tightness or a pushing sensation.
After the procedure
You may require a short stay in the Recovery afterwards before you can go back home. We would like to make sure that:
~ you are comfortable
~ you can stand without feeling dizzy or faint
~ you can weight bear safely and mobilise as is normal for you
~ depending upon your procedure, you are able to swallow fluids without choking or able to go to the toilet and pass urine unaided.
Please ensure that you have made arrangements for someone to collect you after the procedure. You should not drive, operate heavy machinery or work at heights for 24 hours after the procedure. If you have required sedation, you should not sign any legal documents for a period of 24 hours or provide childcare unsupervised.
Follow up plan
As your pain decreases, you should try to gently increase your exercise. Simple activities like a daily walk, using an exercise bike or swimming on your back will help to improve your muscle tone. It is best to increase your activities slowly. Try not to overdo things on a good day so that you end up paying for it with more pain the following day.
A follow up appointment will generally be arranged and you may be requested to fill a form that we use as part of assessments to continuously improve our service.
Information Leaflets for procedures in some
chronic pain conditions
- click to download -
Facet joint injection
Transforaminal epidural injection / nerve root block
Caudal epidural injection
Rhizolysis (Radiofrequency denervation of facet joints)
Sacroiliac joint injection
Stellate ganglion block
Peripheral nerve blocks such as suprascapular nerve / occipital nerve / ilioinguinal nerve etc.
Trigger point injection