What type of injections do you do?
We perform lumbar spine facet joint, perineural/foraminal, translaminar epidural, and transforaminal epidural
injections.
How long does it take?
Once you're in position the procedure is completed within 5-10 minutes.
Do they always work?
While most people get at least some relief with the injections, in some patients they may not work.
How is the procedure performed?
All of our back injections are performed under CT guidance. After talking to the Radiologist (medical doctor
specialised in imaging), you will lie on the CT table on your stomach. A scan is done to localise the target
location. A small mark is placed on your back and local anaesthetic is administered to the skin via a very
small needle, which will sting for 5-10 seconds. A second needle is then placed through the numb area and
gradually advanced to the target, taking images as the needle is advanced. Normally you won't feel this.
Depending on the type of injection, a small amount of CT contrast or other liquid may be injected into the
area to confirm the medication will move to the correct area. Once the needle is in the correct location, the
medication is injected. For more specific information see the other questions below.
What might I experience during a facet joint injection?
For a facet joint injection you will experience a small sting when the anaesthetic goes in. You may also feel a
small sting when the needle touches the joint, and a mild ache or pressure sensation when the medicine is
injected.
What might I experience during a nerve root or epidural injection?
You will experience a small sting when the anaesthetic goes in. When the needle gets close to the nerves
approximately 25% of patients experience some pain in their back or a pain in their leg for a few seconds. This
is quite normal. When the contrast or saline is injected you might also feel some pressure or a pain in your leg
due to the pressure of the fluid next to the nerve. When the medicine is injected you may also feel the same
sensation.
Why might the injection not work?
In the lower back there are 25 different locations that can be targeted for injection. Unfortunately modern
imaging can only give us a guide to where your pain is coming from. The two main reasons you may not get
relief with the injection are that the area chosen may not be the one causing pain, or there may be multiple
areas all contributing to the symptoms. For this reason it is not uncommon to have more than one injection,
targeting the most likely areas. It is also possible that the underlying problem may not be able to be improved
with steroids.
How long do they take to work?
The anaesthetic we inject will work immediately, and depending on the type can last 3-12 hours. The steroid
can take between 2 days and 2 weeks to work. So you may find that you feel good immediately after the
injection, then the next day feel sore (as the anaesthetic has worn off and the steroid hasn't started working
yet), and then gradually start to feel better over the next few days.
Do they hurt?
We do everything we can to minimise the pain of the injection, and for most injections they aren't much worse
than a blood test. Some patients find the injections painful, especially if there is a lot of inflammation in the
area. In this case we simply use more anesthetic as we go.
What are the main risks?
The main risks include a small risk of bleeding and infection. There is a chance that the injection may not
work. For nerve root and epidural injections there is a very small risk of damage or inflammation to the nerves
(1 in 1000 to 1 in 100,000) which normally resolves without permanent issues. If you have diabetes your blood
sugar level may go up for a few days. Rarely people can experience facial flushing, increased alertness, or a
transient increase in blood pressure. The risk of an allergic reaction is extremely rare (these are usually
treated by steroids anyway).
What happens if I am nervous?
That’s quite normal, especially if it is your first injection. Our doctor will go through the procedure with you
before we do anything, and you can ask all the questions you want. If you decide not to go ahead with the
injection, that is fine, so don't feel pressured to have the injection if you are unsure. To put the procedure in
some perspective, epidural anaesthetic is administered to pregnant women every day in hospitals, with no
imaging guidance. By using imaging we are accurate to within 1mm.
Are there any long term side effects?
If you have a lot of steroid injections (generally more than 4-6 a year) then there is a small risk that the steroid
can increase your blood pressure, or reduce your bone density. This is still much lower than people who take
steroid tablets regularly. While we do try to limit the number of injections, if you are in significant pain, that can
cause many other problems for your health, which may be worse than the small risk of side effects from a
steroid injection.
What do I need to bring?
You should bring your recent imaging of the area with you, as well as your referral and Medicare card.
Do I need imaging before my injection?
Yes. We require recent imaging of the area to make sure that we are injecting the correct area, and to make
sure that there isn't some other cause for your pain that we are missing. Especially in the lumbar spine,
different people can label structures differently, so it is essential that we have imaging to clarify the area
being injected. For back injections a CT or MRI in the last 2 years is required.
Can I drive home afterwards?
For facet joint injections yes. For perineural or epidural injections you will require a driver. This is because you
have may some transient numbness or weakness which makes you unsafe to drive.
Do you bulk bill?
Yes, we bulk bill all studies if you have a Medicare card.
Is there any preparation?
No. You should take your normal medications. You do not need to fast.
What is the cost for private patients?
This depends on the study, so please call us and we can give you a quote over the phone.
Do I need to book?
Yes, all injections need a booking.
Does it matter if I am on blood thinners?
If you have the injection while on blood thinners, there is a slightly increased risk of bleeding. On the other
hand, if you stop your blood thinners there is a risk that you make have a heart attack or stroke. Aspirin is
considered safe for all injections. If you are having a facet joint or nerve root injection, all blood thinners are
safe. If you are having an epidural injection then you may need to stop your medication, however you should
TALK TO YOUR DOCTOR BEFORE STOPPING ANY MEDICATION, as there is a risk of harm if you do so, and you
doctor is best placed to assess the safest option for you.
What if I have diabetes?
Your blood sugar may be elevated for the first few days and should then return to normal. For most people
this is only a small increase, however in some patients it can go quite high, so you should check your blood
sugar regularly.
Copyright 2021 Clearview Medical Imaging
LUMBAR SPINE
INJECTIONS
AT CLEARVIEW WE AIM TO MAKE
LUMBAR SPINE INJECTIONS AS
EASY AND PAINLESS AS
POSSIBLE.
A steroid injection is used to reduce pain and inflammation in
your lower back to improve symptoms. We perform a wide
range of lumbar spine (lower back) injections. All injections
are done using imaging guidance by an experienced
Radiologist (a medical doctor specialising in imaging) with
local anaesthetic. For general information on steroid
injections see our main injection page
A Carlisle Health Clinic
What type of injections do you do?
We perform lumbar spine facet joint,
perineural/foraminal, translaminar epidural, and
transforaminal epidural injections.
How long does it take?
Once you're in position the procedure is
completed within 5-10 minutes.
What might I experience during a facet joint
injection?
For a facet joint injection you will experience a
small sting when the anaesthetic goes in. You
may also feel a small sting when the needle
touches the joint, and a mild ache or pressure
sensation when the medicine is injected.
What might I experience during a nerve root
or epidural injection?
You will experience a small sting when the
anaesthetic goes in. When the needle gets
close to the nerves approximately 25% of
patients experience some pain in their back or
a pain in their leg for a few seconds. This is
quite normal. When the contrast or saline is
injected you might also feel some pressure or
a pain in your leg due to the pressure of the
fluid next to the nerve. When the medicine is
injected you may also feel the same sensation.
Why might the injection not work?
In the lower back there are 25 different
locations that can be targeted for injection.
Unfortunately modern imaging can only give us
a guide to where your pain is coming from. The
two main reasons you may not get relief with
the injection are that the area chosen may not
be the one causing pain, or there may be
multiple areas all contributing to the
symptoms. For this reason it is not uncommon
to have more than one injection, targeting the
most likely areas. It is also possible that the
underlying problem may not be able to be
improved with steroids.
Is there any preparation?
No. You should take your normal medications.
You do not need to fast.
Can I drive home afterwards?
For facet joint injections yes. For perineural or
epidural injections you will require a driver. This
is because you have may some transient
numbness or weakness which makes you
unsafe to drive.
Do I need imaging before my injection?
Yes. We require recent imaging of the area to
make sure that we are injecting the correct
area, and to make sure that there isn't some
other cause for your pain that we are missing.
Especially in the lumbar spine, different people
can label structures differently, so it is essential
that we have imaging to clarify the area being
injected. For back injections a CT or MRI in the
last 2 years is required.
What do I need to bring?
You should bring your recent imaging of the
area with you, as well as your referral and
Medicare card.
Do I need to book?
Yes, all injections need a booking.
Are there any long term side effects?
If you have a lot of steroid injections (generally
more than 4-6 a year) then there is a small risk
that the steroid can increase your blood
pressure, or reduce your bone density. This is
still much lower than people who take steroid
tablets regularly. While we do try to limit the
number of injections, if you are in significant
pain, that can cause many other problems for
your health, which may be worse than the small
risk of side effects from a steroid injection.
What happens if I am nervous?
That’s quite normal, especially if it is your first
injection. Our doctor will go through the
procedure with you before we do anything, and
you can ask all the questions you want. If you
decide not to go ahead with the injection, that is
fine, so don't feel pressured to have the injection
if you are unsure. To put the procedure in some
perspective, epidural anaesthetic is
administered to pregnant women every day in
hospitals, with no imaging guidance. By using
imaging we are accurate to within 1mm.
How long do they take to work?
The anaesthetic we inject will work
immediately, and depending on the type can
last 3-12 hours. The steroid can take between 2
days and 2 weeks to work. So you may find that
you feel good immediately after the injection,
then the next day feel sore (as the anaesthetic
has worn off and the steroid hasn't started
working yet), and then gradually start to feel
better over the next few days.
Do you bulk bill?
Yes, we bulk bill all studies if you have a
Medicare card.
Do they hurt?
We do everything we can to minimise the pain
of the injection, and for most injections they
aren't much worse than a blood test. Some
patients find the injections painful, especially if
there is a lot of inflammation in the area. In this
case we simply use more anesthetic as we go.
Do they always work?
While most people get at least some relief with
the injections, in some patients they may not
work.
How is the procedure performed?
All of our back injections are performed under
CT guidance. After talking to the Radiologist
(medical doctor specialised in imaging), you
will lie on the CT table on your stomach. A scan
is done to localise the target location. A small
mark is placed on your back and local
anaesthetic is administered to the skin via a
very small needle, which will sting for 5-10
seconds. A second needle is then placed
through the numb area and gradually
advanced to the target, taking images as the
needle is advanced. Normally you won't feel
this. Depending on the type of injection, a small
amount of CT contrast or other liquid may be
injected into the area to confirm the medication
will move to the correct area. Once the needle is
in the correct location, the medication is
injected. For more specific information see the
other questions below.
What are the main risks?
The main risks include a small risk of bleeding
and infection. There is a chance that the
injection may not work. For nerve root and
epidural injections there is a very small risk of
damage or inflammation to the nerves (1 in
1000 to 1 in 100,000) which normally resolves
without permanent issues. If you have diabetes
your blood sugar level may go up for a few
days. Rarely people can experience facial
flushing, increased alertness, or a transient
increase in blood pressure. The risk of an
allergic reaction is extremely rare (these are
usually treated by steroids anyway).
Does it matter if I am on blood thinners?
If you have the injection while on blood thinners,
there is a slightly increased risk of bleeding. On
the other hand, if you stop your blood thinners
there is a risk that you make have a heart
attack or stroke. Aspirin is considered safe for
all injections. If you are having a facet joint or
nerve root injection, all blood thinners are safe.
If you are having an epidural injection then you
may need to stop your medication, however
you should TALK TO YOUR DOCTOR BEFORE
STOPPING ANY MEDICATION, as there is a risk of
harm if you do so, and you doctor is best placed
to assess the safest option for you.
What if I have diabetes?
Your blood sugar may be elevated for the first
few days and should then return to normal. For
most people this is only a small increase,
however in some patients it can go quite high,
so you should check your blood sugar
regularly.
What is the cost for private patients?
This depends on the study, so please call us and
we can give you a quote over the phone.
Copyright 2021 Clearview Medical Imaging
LUMBAR SPINE
INJECTIONS
AT CLEARVIEW WE AIM
TO MAKE LUMBAR
SPINE INJECTIONS AS
EASY AND PAINLESS
AS POSSIBLE.
A steroid injection is used to reduce pain and
inflammation in your lower back to improve
symptoms. We perform a wide range of lumbar
spine (lower back) injections. All injections are
done using imaging guidance by an
experienced Radiologist (a medical doctor
specialising in imaging) with local anaesthetic.
For general information on steroid injections see
our main injection page.
A Carlisle Health Clinic
