Set-up:

  • The procedure is performed in a sterile setting similar to an operating room.
  • The injection site is cleaned and draped.  Skin numbing medication is injected into and around the procedure site.
  • Before proceeding, the fluoroscopy C-arm is positioned over the patient. Fluoroscopic guidance is used during the procedure to guide the needle into the proper position.

Injection Procedure — Diagnostic and Therapeutic Injections:

  • Brief, mild discomfort (one or two seconds) from the local anesthetic (numbing medication) placed at the skin site (like getting a tooth frozen at the dentist).
  • Little to no discomfort when directing the spinal needle to the target
  • Once the needle has reached the target site, little or no discomfort it typically felt when the contrast (x-ray dye) is instilled (double-checking for accurate needle position).
  • After confirming accurate flow of the contrast, the diagnostic or therapeutic medication is injected. Depending on the patient’s condition, they may briefly (few seconds) feel mild pain or pressure, as the medication is injected in or along the anatomical target (because that structure may be inflamed or irritated).

Injection Procedure — Discography: In contrast to diagnostic “blocks”, the goal of provocative discography is to replicate the patient’s typical discomfort (symptoms). The patient’s experience is similar to the that of a typical diagnostic block, until the final step:

  • Brief, mild discomfort (one or two seconds) from the local anesthetic (numbing medication) placed at the skin site (like getting a tooth frozen at the dentist).
  • Little to no discomfort when directing the spinal needle to the target
  • Once the needle has reached the target site, inside the disc, they will typically feel one of  two sensations as the contrast (x-ray dye) is instilled into the middle of the disc:
    • If the disc is not a source of pain, they may feel absolutely nothing or they may feel pressure.
    • If the disc is their source of pain, they will feel moderate pain that replicates their daily pain experience (re-creates “your” pain).

Injection Procedure — Radiofrequency procedures: to be discussed in a separate section on this website.