Types of Injections
Injections are performed by a pain specialist. The goal is to obtain diagnostic information about your pain generator while also providing therapeutic relief. The key to lasting pain relief is to strengthen the core muscles and essentially create a brace out of your own muscles during the period of pain relief after the procedure.
Trigger Point Injection
These injections are done without imaging. The steroid and anesthetic solution is injected into a muscle that is causing pain. A trigger point injection will provide some relief so that your exercise program can be ramped up to hopefully alleviate the underlying cause.
Epidural Steroid Injection (ESI)
The first type of ESI is a Transforaminal (TF ESI), where the anesthetic and steroid solution are injected into the epidural space of the spinal canal through the foramen (gap) of a targeted level. This is different than an Interlaminar ESI where the solution is injection into the interlaminar space and spreads over multiple levels.
The injections target a specific facet joint to be treated (where two vertebrae meet). During a Facet Block, the solution of anesthetic and steroid is injected into the joint, whereas during a Medial Branch Block (MBB) the solution is injection just outside the joint. Radio Frequency Ablation (RFA) is just for long-term pain relief. A probe is used to ablate/burn the tiny nerve endings so that they no longer send pain signals. The tiny nerves will grow back, but this can take 6=12 months.