The intervertebral discs are fibrous, quarter-sized cushions positioned between each of the 24 vertebrae of the spine. These discs form joints, which hold the bones of the spine together, maintain spinal alignment, and allow the back to twist, bend, and move. An intradiscal injection is done to diagnose and treat disorders of the discs.

What is the difference between a diagnostic disc injection and a therapeutic disc injection?

With a diagnostic disc injection, the doctor injects a local anesthetic into the disc to determine which disc is causing back pain. With a therapeutic disc injection, the doctor injects a long-acting corticosteroid into the disc to reduce inflammation and offer long-term pain relief.

Why are disc injections performed?

According to statistics, around 90% of Americans experience some type of back pain during their lives. Low back pain is a common problem among adults, and discogenic back pain is chronic in nature, described as aching, nagging, and/or throbbing. Intervertebral disc injections are performed to relieve this form of back discomfort, which occurs from degenerative disc disease and spinal arthritis.

What is disc regenerative therapy?

Disc regenerative therapy (DRT) is a new promising option for treating discogenic back pain. This procedure triggers the body’s natural healing mechanisms to relieve pain and improve degenerative disc disease. DRT treatment promotes healing of injured disc through the injection of dextrose and glucosamine solution into the center of the intervertebral disc. This injectable solution stimulates the growth of new collagen fibers, which increases the disc strength.

At times, injections into the disc involve steroid medication and not the dextrose/glucosamine variety.

What should I expect before the disc injection procedure?

To determine if you are a candidate for a disc injection, the Nashville pain doctor will take a medical history, ask you questions about your back condition, and perform a detailed physical examination. Be sure to discuss all your current medications with the doctor. You are usually not allowed to eat or drink after midnight the day of the procedure, but small sips of water are allowed with medications.

How is a disc injection performed?

When you arrive at the pain management center, the nurse will place an intravenous (IV) catheter into your arm. In addition, you will be given precautionary antibiotics and a mild sedative. After being positioned on your abdomen, the doctor will anesthetize the skin and soft tissues of the back with a local anesthetic. After determining the damaged disc, using x-ray guidance, the doctor will insert a small needle into the disc to administer the medication or solution.

What can I expect after a disc injection?

After the disc injection procedure, you will be moved to a recovery area where a nurse will monitor you for around 30-40 minutes. Expect some mild pain at the site of injection as the anesthetic wears off. The discomfort could last for up to 2 days, but usually wears off after 12-24 hours. To alleviate pain, use an ice pack 3-4 times a day for around 20 minutes.

Are intradiscal injections effective?

In a recent blinded, randomized, and controlled study, intradiscal injections of corticosteroid were found to be effective and safe for treating chronic low back pain. In another study, the success rate for disc injections was more than 65%, with pain relief lasting an average of 112 days. Additionally, a pilot study proved that DRT significantly improved low back discogenic pain.

Resources

Cao P, Jiang L, Zhuang C, Yang Y, et al. (2011). Intradiscal injection therapy for degenerative chronic discogenic low back pain with end plate Modic changes. Spine Journal, 11(2), 100-106. doi: 10.1016/j.spinee.2010.07.001

Mae T. Terada T, Haruyama N, et al. (2012). Intradiscal pressurized physiologic saline injection drastically reduced pain from cervical and lumbar disc herniation. J Pain, 13(4):S89.

Muzin S, Issac Z, & Walker J (2008).The role of intradiscal steroids in the treatment of discogenic low back pain. Curr Rev Musculoskelet Med, 1(2), 103-107. doi:  10.1007/s12178-007-9015-y