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Spinal Pain13 min read

Spinal Injections: A Guide to Every Type and What They Treat

TL;DR

Spinal injections are the cornerstone of interventional pain management — a family of minimally invasive, image-guided procedures that deliver medication directly to the anatomical source of spinal pain. From epidural steroid injections for disc herniation to facet joint injections for arthritis, medial branch blocks for diagnostic confirmation, and intradiscal injections for discogenic pain — each type targets a specific pain generator with precision that oral medications cannot achieve. This guide explains every major spinal injection type, its target, and what conditions it treats.

Key Features

  • Multiple injection types for different pain sources
  • Fluoroscopy or ultrasound guidance
  • Diagnostic and therapeutic applications
  • Outpatient procedures — no hospital admission
  • Contrast dye confirms accurate placement
  • Covered by most major insurance plans

Key Benefits

  • Targeted relief at the exact pain source
  • Avoids systemic medication side effects
  • Diagnostic value — confirms pain generator
  • Enables participation in physical therapy
  • Delays or avoids surgical intervention
  • Repeatable with appropriate intervals

The Complete Guide to Spinal Injection Types

Epidural Steroid Injection (ESI)

Target

Epidural space around the spinal cord

Treats

Disc herniation, spinal stenosis, radiculopathy (sciatica, cervical radiculopathy)

Delivers corticosteroid + local anesthetic into the epidural space to reduce nerve root inflammation. Three approaches: interlaminar, transforaminal, and caudal.

Facet Joint Injection

Target

Facet joint (zygapophyseal joint) capsule

Treats

Facet joint arthritis, cervical/lumbar facet syndrome

Intra-articular injection of corticosteroid + local anesthetic into the facet joint. Provides both diagnostic confirmation and therapeutic relief.

Medial Branch Block

Target

Medial branch nerve adjacent to facet joint

Treats

Facet joint pain — diagnostic prerequisite for RFA

Local anesthetic injection adjacent to the medial branch nerve. Primarily diagnostic: ≥50–80% relief confirms candidacy for radiofrequency ablation.

Sacroiliac Joint Injection

Target

Sacroiliac joint

Treats

SI joint dysfunction, sacroiliitis, post-partum SI pain

Fluoroscopy-guided injection into the SI joint. Confirms SI joint as pain source and provides therapeutic anti-inflammatory relief.

Selective Nerve Root Block (SNRB)

Target

Specific nerve root at the intervertebral foramen

Treats

Radiculopathy from disc herniation or foraminal stenosis

Transforaminal injection targeting a specific nerve root — both diagnostic (confirms the symptomatic level) and therapeutic (reduces nerve root inflammation).

Trigger Point Injection

Target

Myofascial trigger points in muscle

Treats

Myofascial pain syndrome, muscle spasm, referred pain

Injection of local anesthetic (with or without corticosteroid) directly into hyperirritable muscle knots to release spasm and interrupt referred pain patterns.

Not Sure Which Injection Is Right for You?

Our board-certified pain specialists will evaluate your condition and recommend the most appropriate injection type. Schedule at NYC Pain Management in Rego Park, Queens.

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