Spinal injection for back pain

Okay, so we're going to talk about having some spinal injections today. I will assume that you've never had these before. It's quite a quick, easy procedure. Most people are not anaesthetised. They have a bit of sedation through a drip in their arm and it makes them a bit sleepy and generally they don't remember afterwards. What we do is we take you into the operating room, get you to lie on your front, so on your tummy, get a big x-ray machine in there and we can find exactly where the problems are by looking at the x-ray and where the wear and tear is in your back. We already know because we've seen your scans, but it's always good to check. What we'll do is a series of x-rays. Depending on where your problem is, put some very thin needles right into the back. We use the x-ray to guide us. Once we know that the needle is in the correct place in the various bones of your back, put in a small amount of a mixture of local anaesthetic and steroid. Depending Depending on how much wear and tear you've got on your back, we can do a minimum of one injection but we can do up to about nine or ten at the same time. At the beginning of the procedure, we give your back a bit of anaesthetic and that's the bit that hurts the most to be honest. Once we've numbed the skin, you shouldn't feel much when the actual needles go in. Occasionally people notice a bit of pushing sensation in the back or in the legs but generally it's very well tolerated. At the end, when we get rid of all the needles, you'll have some small elastoplast dressings on your back and they're just treated like any other dressing. Once they fall off in a couple of days, you can leave them off. Then we get you back onto your back and into the recovery and some people do notice a little bit of a headache afterwards, which is why the nurses will make you drink lots of fluid and get you to lie flat on your back for at least the first half an hour. If the injections work, and we really hope that they do, I'm afraid they are usually temporary. Sometimes people have one or two injections and the pain in their back or in their leg completely goes, but often it's an incomplete recovery. Most of the time people will notice that the pain will come back in about four months' time. If you do have a really good result and it wears off, when we see you again in the clinic we can talk about having the injections repeated. Things you need to know is even when you go home, you need to keep this in the back of your head, is that very occasionally when we put the needle in, they are very thin needles, but they can sometimes cause irritation to the nerves going down into the legs. Something to watch out for is called Cauda Requina Syndrome, and that's when you suddenly feel like you want to pee and you can't, or you want to poo and you can't. Or the opposite, which is you look down and you've soared yourself and you wet yourself and you didn't realise. If that happens to you, and there's a very very low chance of this happening, please do come back to the hospital whether it's day or night. At night do go to A&E because that is an emergency. But I don't want to worry you too much, that is very very rare.