Spine Injections: What You Need to Know

How does it work? Is it right for me? Will it hurt? Get answers here.

Spinal injections can be great intermediate back pain treatments if your pain is sticking around despite rest, physical therapy and other conservative treatments, but you’re not quite ready for surgery. For many people, however, the thought of a needle in the back is unappealing to put it mildly.

We know you have questions about the spinal injection procedure, and we have answers. Here’s how to know if you’re a good candidate, what to expect from the procedure, how to prepare, and more.

Epidural spine injectionSpine injections are a middle ground between nonsurgical and surgical treatment.

What medical conditions might disqualify me from receiving an injection?

Deciding to get a spine injection is a personal decision that should be made in consultation with your health care provider. Your provider can help explain the risks and benefits of the procedure and lay out appropriate, evidence-based injection options based on your conditions, preferences, and other factors.

There are few absolute disqualifying conditions. They include:

  • New onset pain thought to be from trauma, cancer or an infection
  • Compression of the spinal cord or cauda equina (a bundle of nerves in the low back) that’s causing progressive neurological deficits

Some people for whom the risks might outweigh the benefits include those who:

  • Have poorly controlled diabetes
  • Have a severe bleeding disorders
  • Are immunocompromised

A recent infection or severe allergy to a medication found in the injection may also be a disqualifying condition. Women who are pregnant sometimes choose to undergo a spinal injection after delivery to avoid being exposed to radiation.

Do I need medical clearance from another doctor?

You are unlikely to need medical clearance from your doctor unless you are going to have the injection under sedation. The doctor will determine whether you are an appropriate candidate to receive anesthesia.

Do I need to stop my blood thinners?

In most cases, you will be asked to stop your blood thinning medication prior to the injection. You may be asked to stop the medication anywhere from 6 hours to 10 days before the procedure. You are usually allowed to restart the blood thinner within 24 hours of the injection.

The decision to stop taking your blood thinning medication is based on a variety of factors including:

  • Type of blood thinner
  • Why you’re prescribed a blood thinner
  • Type of injection you’re Having

You, the physician performing the injection, and the doctor who prescribed the blood thinner should all be involved in the decision of how to manage your blood thinning medication prior to your injection.


Talk to your doctor about spine injectionsTalk to your doctor about how spine injections may interact with other medication you're taking.

What other medications do I need to stop taking? 

Blood thinners aside, you should take your medications as you would normally with a small sip of water. Nonsteroidal anti-inflammatory drugs (NSAIDs,e.g. ibuprofen, naproxen) and aspirin may need to be held prior to certain spinal injection—usually those involving the cervical spine, as they can increase your risk of bleeding. The decision to hold NSAIDs and Aspirin prior to injection should be discussed with your doctor before the injection.

Is a spine injection painful?

Spine injections can cause some mild discomfort but are usually well-tolerated. In most cases, the physician performing the spinal injection will use a local anesthetic to numb the area where the injection will take place, similar to how dentists will numb a patient’s teeth with an injection prior to starting a procedure.

In some cases of spinal injections, sedation may be used. Sedation can be delivered in the form of a pill or through an IV. Benzodiazepines are the most commonly used class of sedatives. The type of spinal injection, how long the procedure will take, your overall health, and your preference are all important factors to consider when deciding to use sedation with a spinal injection.

Do I need to stop eating and drinking?

If you‘ll be sedated you will need to stop eating and drinking about 8 hours before your procedure. There is some variability on fasting instructions for spinal injections performed without sedation. Some centers require no fasting while others require you to not eat or drink anything after midnight on the day of your injection.  

What should I bring to my spine injection?

Bring your insurance card and a photo ID. Wear comfortable, loose fitting clothes. If you have diabetes, bring you diabetic medication to the appointment.

What should I leave at home?

You should leave your valuables at home. Do not bring young children to the appointment as they will be unable to enter the procedural area with you.

Do I need to have someone drive me home after a spine injection?

Unless you’re having a trigger point injection, you will need to have someone drive you home. Trigger point injections are usually dry needling or just local anesthetic—definitely no sedation—so you should be able to drive yourself home. Some facilities require that your driver accompany you to the procedure and stay in the waiting room until the procedure is over.

What happens during the spinal injection procedure?

After checking in, you may be asked to change into a gown. It is usually a good idea to use the restroom prior to the procedure. The procedure will be performed on a table that permits you to lie comfortably on your stomach or side. Most injections are performed with the aid of an X-ray machine that is located above the table.

The skin over the injection site will be cleaned with an antiseptic solution. Local anesthetic medication will then be injected in and around the injection site to numb the area. Once the local anesthetic has taken effect, your spine specialist will insert a needle into the predetermined spinal region. Contrast dye and an X-ray will guide the needle to the appropriate location. The medication, usually a combination of a local anesthetic and steroid, will then slowly be administered.

What happens after the spine injection procedure?

After the procedure, you will be monitored to ensure that you’re not having any side effects from the medication. You’ll receive discharge paperwork and follow-up instructions. The injection can take a few days to take full effect. You may be asked to keep a pain diary so you can record your response to the injection.

Are there any activity restrictions after the procedure?

You should avoid strenuous activity and driving for the remainder of the day. You can usually return to your normal activities 24 hours after the injection.          

Can I shower after the procedure?

Most physicians will allow you to shower the same or next day. Submerging yourself in a bath, pool, or hot tub is usually allowed 24 to 72 hours after the injection.    

You’re armed with knowledge and have had your questions answered. Ready to schedule your spinal injection? Find a spine specialist near you who can help.


Updated on: 03/17/20
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