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Learn about interventional radiology
Massachusetts General Hospital Imaging provides spine injection, an image-guided treatment for pain, on the Mass General main campus.
When should I consider a spine injection?
The two major reasons to perform a spine injection are to determine whether particular nerves or joints are causing your symptoms, and to provide temporary pain relief. Although these goals are usually achieved, it is impossible to guarantee that the cause of your pain will be identified, or that your pain will be decreased. The period of relief is different in each patient.
The specialized radiologists who perform spine injections at Mass General are board certified in general radiology and fellowship trained with additional specialization in image-guided musculoskeletal procedures. In addition, each has extensive training in the use of X-ray equipment, contrast, and image interpretation.
Our team of radiologists and nurse practitioners coordinates a patient's complete care—from imaging evaluation to post-procedure followup—maintaining a high level of communication with the patient throughout the process. In addition, Mass General Imaging works in close coordination with experts from across Mass General when necessary.
What should I expect BEFORE a spine injection?
Before your appointment, we will call you to screen you for anything that may interfere with the procedure, such as allergies to X-ray contrast, diabetes, and any current infections.
Please plan to bring the most recent MRI or CT scans of your spine to the procedure, as well as a list of current medications and doses you are taking. If your symptoms are mild, do not take pain medications before the procedure. Please arrive 30 minutes prior to your appointment.
What should I expect DURING a spine injection?
The procedure takes about 30 minutes. Depending on the procedure, you will either lie on your stomach or back and must be able to turn your head. Your skin will be cleaned with an antiseptic soap, and then numbed with a local anesthetic. Using fluoroscopy (continuous X-ray), the radiologist will pass a needle into the area of your back that is believed to be causing your pain. A very small amount of contrast dye will be injected to confirm correct needle position, and then the medications will be injected. During the injection, you may feel mild pressure or tingling. These sensations are expected and will only last several seconds. Please inform the radiologist if you feel these sensations, as it will help to diagnose the exact source of your pain. Two different medications are injected around the targeted area. A short-acting anesthetic agent is injected for diagnostic information. If your pain is relieved immediately following the procedure, it will come back after the anesthetic agent wears off in about 1 to 5 hours, depending on the specific area being treated. An anti-inflammatory steroid is injected for longer-lasting pain relief, but it will not begin working for 1 to 2 days. The steroid reaches maximum effectiveness in 5 to 7 days. The duration of relief depends on many factors, including the severity and reversibility of your condition.
What should I expect AFTER a spine injection?
You will receive discharge instructions and a pain diary to record the changes in your symptoms. You will not be allowed to drive, however you can leave the hospital immediately if you have someone who can drive you home and stay with you for up to 5 hours. The short-acting anesthetic can make your arms and legs feel numb or weak for up to 5 hours. You should minimize activity during this time, and then resume routine light activities as tolerated. You should not drive a car until your arms and legs feel normal. Avoid any strenuous activity or heavy lifting for 7 days.
What risks are associated with spine injections?
Complications are infrequent but possible. The needle could cause local bleeding or infection. Rare complications include allergic reaction to the contrast or anesthetic. If the anesthetic spreads to nearby nerves, you may develop temporary arm or leg weakness or numbness. Pain may be temporarily worsened after the procedure.
Department of Radiology Chairman Emeritus James H. Thrall, MD, explains how the ability to see deep inside the body has driven the development of minimally invasive methods of treatment—a trend in which Mass General Imaging has played a key role.
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