Spinal

Experiencing spinal problems and/or discomfort at any age can be concerning.

Facet, sacroiliac and piriformis joint injections, among other treatments usually offered to patients experiencing issues in the joints, spine or surrounding areas.

Facet Joint Injections

The facet joint is the joint between the vertebra in your back along with discs. Over time these can wear down and become arthritic, leaving you in pain and stiff. A facet joint injection usually takes less than 30 minutes and is performed using local anaesthetic.

Sacroiliac Joint Injections

A sacroiliac injection (also known as a ‘sacroiliac joint block’) is the joint between your spine and your pelvis. Over time, this can wear down, causing extreme discomfort and severely impacting your life. It is usually used to diagnose or treat lower back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.

Piriformis Joint Infections

A piriformis injection is used to treat patients who suffer from irritation, swelling and tightness in the piriformis muscle, located in the hip/buttock region. A steroid is injected into this muscle which reduces pain and swelling and can decrease the pressure on the affected nerves.

GlobMed understands how debilitating spinal conditions and back pain can be. That is why we have experts in all aspects of spinal surgery covering simple joint injections to more complex procedures such as laminectomies and discectomies.

Symptoms

Those affected by problems with their facet joint may experience the following symptoms:

• Localised pain: Pain present in the lower back
• Referred pain: Pain present in the buttocks, hips, thighs or knees (and sometimes the abdomen or pelvis)
• Radiating pain: This is a spinal nerve is irritated or compressed at the facet joint, a sharp shooting pain may radiate into the buttock, thigh, leg and/or foot
• Tenderness on palpitation: Pain is more pronounced when the area over the affected facet in the lower back is gently pressed
• Effect of posture and activity: Pain is worse in the morning, after long periods of inactivity, after heaving exercise and/or while rotating or bending the spine backwards
• Stiffness: If the facet is in pain due to arthritic conditions, stiffness could potentially be present in the joint
• Crepitus: Arthritic changes in the facets may create feelings of grinding or grating in the joints upon movement

Those affected by problems with their sacroiliac joint may experience the following symptoms:

• Numbness, tingling or feeling of weakness in the leg
• Pain in the lower back
• Pain in buttock
• Pain that radiates up to the lower hip, groin or upper thigh
• Pain occurring on one or both sides

Those affected by problems with their piriformis joint may experience the following symptoms:

• Numbness and tingling in the buttocks that may extend down the back of the leg
• Tenderness of the muscles in the buttocks
• Difficulty sitting comfortably
• Pain while sitting that gets worse the longer you sit
• Pain in the buttocks and legs that worsens with activity

When Should I Visit a Spinal Doctor?

It is very common to experience minor joint pain from time to time. But when you begin experiencing severe or persistent pain or affecting your ability to complete daily activities, it may be time to seek medical help. At GlobMed, we understand the impact this can have on your life and everyday living; we work hard to find the highest quality spinal surgeons to help you get back to feeling normal again.

Spinal Procedures Explained

Facet Joint Injection

Facet joint injection will usually be no more than a 30-minute procedure under local anaesthetic, with a small injection of steroid and anaesthetic into your back around the affected and problematic joint. It is often aided by X-Ray or ultrasound. You should be able to go home after the injection and return to regular activity a day or two afterwards.

Sacroiliac Joint Injection

Depending on the patient’s preference, an intravenous line may be inserted to deliver medication to help the patient relax. The needle insertion site is often numbed using local anaesthetic. Once the needle enters the sacroiliac joint, contrast ‘dye’ (that shows up under X-ray) is injected to verify needle placement within the sacroiliac joint and the spread of solution within the joint.
Then, once the needle has been guided into the joint successfully, diagnostic and therapeutic medications are injected into the joint.

Piriformis Joint Injection:

Piriformis joint injection is done using a special x-ray to view and then numb the area with a local anaesthetic. The doctor may inject contrast and then inject a drug (steroid + numbing agent) into the piriformis muscle. The procedure usually takes around 10 minutes, and the patient remains awake throughout the procedure.

Risks

Spinal surgery and associated procedures require delicate care and attention. Due to the delicate and intricate nature of the human spine and, therefore, spinal surgery, a great deal of care and attention is needed. Furthermore, there are some specific risks to consider, which should be discussed with your doctor or surgeon before undergoing any spinal procedures or surgery. These may include:

• Repeated injections required over time
• Pain
• Bruising/bleeding
• Allergic reaction to local anaesthetic
• Nerve injury (temporary or long term)
• DVT
• Paralysis (in sporadic but severe cases)

Other spinal treatment options include:

• Nerve root block: (see earlier)
• Lumbar decompression: Lumbar decompression is a surgery used to treat compressed nerves in the lumbar spins when non-surgical treatments have not helped. It can help with persistent pain, pins and needles in the buttocks and hip. This treatment is designed to relieve the pressure on the affected nerve.
• Laminectomy: A section of bone is removed from the affected vertebra to relieve pressure
• Discectomy: A section of the disc is removed to relieve pressure.
• Spinal fusion: Vertebra is joined or fused to stabilise the spine and help stop any pressure on nerves.

The above treatments are usually carried out under general anaesthetic with a local anaesthetic injected at the end to make you more comfortable when waking up. The operation in each case usually lasts for a few hours but can be longer. Patients can expect to be in hospital for 2-3 days. However, they will usually be capable of walking the following day and can return to normal function 6-8 weeks after any operation.

Costs of Spinal Surgery and Treatments

1. Spinal surgery typically costs more than £12,000, and the price can rise depending on the procedure’s level of complexity.
2. The waiting time for spinal surgery (non-urgent) in the UK is supposed to be 18 weeks. However, you may well find that waiting times on the NHS are much longer, often leaving patients in pain over a long period of time, whilst having an effect on your daily life.