When you think of the diagnostic process at a medical appointment, your mind probably jumps directly to a physical exam performed by a physician or medical imaging, like an X-ray, MRI or CT scan. These are the most common techniques that doctors use to reach a specific diagnosis, but they are far from the only options that are available. Oftentimes spine specialists rely on a special injection to help determine a diagnosis. This is known as a diagnostic injection, and in today’s blog, we take a closer look at why they are effective and some of the more common diagnostic injections that may be used to help pinpoint your back issue.
Why Diagnostic Injections Are Effective
Imaging tests can tell us a lot about what’s going on inside the body, but one major thing that they cannot replicate is pain. Your doctor may be looking at a column of degenerative spinal discs on an X-ray, but this still image won’t always tell them precisely where the issue is located. These imaging tests allow a doctor to get an inside view, but their use is limited. Similarly, a physical exam allows a doctor to apply pressure to a specific area or have the patient perform certain movements, all while asking the patient about their current experience, but because everything happens outside the body, a physical exam still sometimes struggles to pinpoint the precise disc or nerve that is affected.
That’s where diagnostic injections come in. With the help of X-ray guidance, a provider can maneuver the injection into the precise location in order to stimulate or numb specific areas, telling the doctor exactly where the problem is housed. And while local anesthetics are oftentimes used, the patient is awake during these injections so that they can let the doctor know if they are experiencing symptoms or pain relief, as this can signal when the problemed location is found.
Common Types Of Diagnostic Spinal Injections
Here’s a closer look at some diagnostic injection techniques that may be used to help determine exactly what you’re dealing with.
- Discography – During a discography, a real-time X-ray called a fluoroscopy is used to allow the doctor to navigate the injection to a particular site as needed. A contrast dye is injected into the center of certain discs, and the patient is asked to describe what they are feeling. A discography is commonly used before spinal disc surgery to determine how many discs need to be surgically addressed.
- Facet and Medial Blocks – If your spine specialist believes joint inflammation is causing problems in your spine, they may recommend a facet or medial block. This involves injecting a steroid into one or more spinal structures. Facet joint blocks are injected into the spinal joint, while medial blocks are injected outside of the joint near a specific nerve. If the injection provides pain relief, the doctor has found the area of concern.
- Sacroiliac Joint Injection – Your sacroiliac (SI) joint is the largest joint in your spine, and it is housed in your lower back. A pain-relieving injection can be guided into this large joint to see if it is indeed the affected area.
- Selective Nerve Root Block – A selective nerve root block (SNRB) is a type of diagnostic injection that helps to pinpoint which spinal nerve is the source of pain. An injection is delivered to a specific nerve root, and if symptoms fade, the pain source is identified. A spine surgeon can usually test one spinal level with an SNRB every 15-30 minutes as they work to determine the problemed nerve root.
Dr. Sinicropi routinely uses diagnostic injections to help determine an issue and help his patients, and he’d be happy to do the same for you. For more information, or for help with a different spinal issue, reach out to Dr. Sinicropi and the team at The Midwest Spine & Brain Institute today at (651) 430-3800.
