Steroid injections, nerve blocks and trigger points ... Oh My!

Managing chronic pain is an important, but particularly difficult task. In most cases, patients turn first to their primary care provider for help, which may include lifestyle modifications, physical therapy, counseling, alternative pain management techniques, NSAIDS (such as Aleve or Motrin), or prescription medications.

When these strategies are ineffective, patients may be referred to a specialist in interventional pain management. These subspecialists treat pain with invasive techniques such as facet joint injections, nerve blocks, lumbar, cervical and thoracic epidurals, occipital nerve blocks, and trigger point injections.

Epidural steroid injections have been used for the treatment of low back problems and sciatica since 1953 and are still an integral part of the non-surgical management of these conditions. At times, and ESI alone is sufficient to provide relief, but often is paired with a comprehensive rehabilitation program to provide additional benefit.

Cervical epidural steroid injections are administered to relieve pain in the neck, shoulders and arms caused by a pinched or inflamed nerve in the cervical spine. Conditions treated include herniated discs, spinal stenosis and arthritis.

Facet joint pain occurs when one or more of the facet joints in the neck or back become irritated and swollen. During a facet joint injection, medication is injected into the facet joint space. The duration of bone and joint pain relief varies depending on the medications used. Typically performed as a test injection, the procedure can provide several hours of pain relief. In some instances, it can provide prolonged relief.

An occipital nerve block is an injection of numbing medication and cortisone (steroid) into the scalp at the back of the head. The occipital nerve block is used in the diagnosis and treatment of occipital neuralgia (nerve pain) or tension headaches.

Trigger point injections are performed to relieve tenderness or as treatment for pain. A trigger point is a knot or tight band of muscle that can be felt under the skin and forms when a muscle fails to relax. During a trigger point injection procedure, a small amount of local anesthetic, with or without steroid, is injected.

These treatments – and others – are available at King’s Daughters Medical Center in Ashland and King's Daughters Medical Center Ohio.