Definition and Overview

Rheumatoid arthritis, osteoarthritis, and chronic migraines are just some of the medical disorders that can cause severe pain. In the early stages, the pain can usually be managed using over-the-counter pain relief medications, such as non-steroidal anti-inflammatory drugs (NSAIDs). As the condition progresses, NSAIDs may no longer be effective, creating a need for a stronger form of pain medications such as pain medicine injection.

The idea of having an injection may not sound quite appealing to some people, but the promise of a longer pain-free period after the injection can easily change their minds. In some cases, the only alternative is to undergo surgery, which many want to avoid due to a wide range of risks and possible complications.

Pain medicine injections usually have a long-lasting effect. For example, corticosteroid medications that are injected into affected joints can provide pain relief for up to six months.

In addition to medical conditions, pain medicine injections can also be used to provide immediate relief from overuse and acute injuries, muscle pain, back pains, and even headaches.

Pain medicine injections can be categorized according to the part of the body they are used on -- joints, soft tissue, and nerves.

  • Joint injections, as the name suggests, are used to relieve joint pains. This type of medication is injected directly into the affected joint with the aid of an x-ray device to help the doctor guide the needle to the exact location.

  • Soft tissue injections are used to provide pain relief from a condition called bursitis, which is the inflammation of small fluid-filled sac located between the bones and tendons.

  • Nerve block injections relieve pain by preventing the pain signals from reaching the brain through the nerve pathways. These types of injections are normally used during surgery and will only be effective for a short period.

In addition to the three basic categories, pain medicine injections can also be used to relieve muscular pain, commonly referred to as trigger point injections. These types of injections help the muscles relax and also reduce inflammation. Trigger point injections are usually a combination of corticosteroid and anesthetics.

Who Should Undergo and Expected Results

Pain medicine injections are mostly prescribed to patients with severe or chronic pain that can no longer be relieved by NSAIDs. For chronic pain, injections would even be better than a long-term use of NSAIDs. The effects of pain medicine injections are often immediate, but in some cases it may take a few days. However, most of the time, the patient can expect pain relief for three to six months.

If you’re experiencing severe or chronic pain and concerned about the negative side effects of NSAIDs, it is best to talk to your doctor about pain medicine injections.

How Does the Procedure Work?

Only specialists that are trained to administer pain medicine injections are allowed to perform such procedures, especially if it is used to relieve joint pains. The process is often complicated and needs to be performed with precision, which is why X-ray devices are used to help the doctor guide the needle to the exact point where the medication should be injected.

Patients that are administered with a pain medicine injection normally undergo an observation period before being released to check for any adverse reactions.

Possible Complications and Risks

Pain medicine injections do have side effects, but not everybody who undergoes the procedure experiences them. The most common side effects or complications are infections, allergic reaction, hematoma, severe toxic reaction, confusion, and loss of consciousness.

Infections are usually the result of poor aftercare of the injected site. Thus, it is important to keep the area clean until the wound has fully healed.

Allergic reactions are uncommon, usually because patients are normally given an allergy test prior to the actual injection. However, some patients experience dizziness, vertigo, hypertension, anxiety, nausea, and tachycardia.

Severe toxic reaction usually occurs in the event of an overdose. This leads to loss of consciousness, hypotension, brachycardia, respiratory depression, and cardiac arrest. If the symptoms are not treated immediately, a severe toxic reaction can lead to complete respiratory and cardiovascular failure that could eventually resulting in death.

Aside from the possible complications, the procedure itself presents risks, which include direct neural damage. This usually happens due to the negligence of the practitioner or lack of skill. However, even highly skilled and experienced practitioners may cause the damage.

References:

  • Benzon, H. Raj's Practical Management of Pain, Mosby, 2008.
  • Canale, S. Campbell's Operative Orthopedics, Mosby, 2008.
  • American Academy of Neurology: "Assessment: Use of Epidural Steroid Injections to Treat Radicular Lumbosacral Pain."
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