The way injections are given can increase pain

When it comes to offering injections to help soothe back pain, many clinicians believe that how they approach the injection site with the needle is merely a matter of comfort and preference on their behalf, but now new research has found that the way a needle is injected can actually influence the amount of pain that the patient feels.

The American Society for Regional Anesthesia and Pain Medicine found that if the drug injection is administered using the lateral parasagittal (PIL) approach then the amount of pain that will be felt short term from the injection will be reduced. This is in contrast to the standard lumbar epidural steroid injections (LESI) that are used when unilateral lumbosacral radiculopathic pain was present.

Chairman of the Department of Anesthesiology at Advocate Illinois Masonic Medical Centre, Kenneth D. Candidio MD, stated that the parasagittal approach is now recognised as the best choice with the mid line approach used only on patients that suffer from isolated lower back pain or bilateral leg pain.

Previous studies by Dr. Candido’s group did not show that the PIL approach was any better than any other option for injecting steroids into the back of someone suffering from other types of back pain, in which the spinal nerve inflammation is located in the ventral or anterior space. From this point they attempted to compare the PIL approach in patients that needed LESI in which it was found that the PIL injection was much better received than the MIL approach.

In order to reach their conclusion Dr. Candido selected a random test group of 22 patients to receive their LESI treatment via the MIL approach and another 22 that would receive the LESI injection with the MIL approach. Each of these patients had a history of unilateral lumbosacral radioculopathic pain as well as bulging, herniated, or degenerated disks.

Each of the groups was monitored over the course of 28 days and it was found that the pain in patients that received the PIL approach was greater than in patients that had received the MIL approach.