Why Fluoroscopy is Recommended For Interventional Pain Management and Epidural Steroid Injections

Interventional pain management, such as epidural steroid injections, can provide immense pain relief for patients at a pain center. In conjunction with treatments such as physical therapy, chiropractic treatment, pain medications, and spinal decompression therapy, spinal injections can provide an extremely effective weapon in a pain doctor's armamentarium to help patients.

In order to make sure the spinal injection provides the optimal chance of being effective, pain doctors should utilize available equipment to ensure the injection is being administered accurately. One of the main pieces of equipment currently available is fluoroscopy. Fluoroscopic guidance refers to an x-ray machine that is shaped like a large C and allows pain management doctors to see in real time a patient's skeletal anatomy. This anatomy is used for real time guidance to ensure accurate needle placement.

Without using fluoroscopy for epidural steroid injections, studies have shown there is a "miss" rate of 40% for placement of the steroid injection. The effectiveness of an epidural injection may mean the difference between a patient receiving pain relief versus heading off to spinal surgery. So if the steroid injection misses its mark, then a disservice has been done to the patient. A pinched nerve causing sciatica may debilitate a patient causing lost time from work, depression, inability to play with the kids, etc.

Facet injections can help relieve back and neck pain from arthritis in those small joints. They are about the size of a thumbnail, and not easily accessible without the assistance of a fluoroscopic machine for guidance. Considering that one can only receive facet blocks every few months, accuracy once again is very important.

Transforaminal epidural steroid injections in either the cervical spine or lumbar spine require significant accuracy that only fluoroscopy x-ray guidance can provide. Most pain doctors will place the needle under fluoroscopy and then inject dye into the area for placement. This is called an epidurography.

Using a real time x-ray machine, fluoroscopy, is essential for a pain management doctor to ensure accuracy and optimal effectiveness for patients' pain relief.