TREATMENTS
For some people living with persistent pain, carefully selected injections can play an important role in diagnosis, pain relief and rehabilitation. Injection treatments are not a cure for chronic pain, and they are not appropriate for everyone. However, when used for the right person, at the right time, they can reduce pain, improve movement and create an opportunity to regain strength and confidence. At Wye Sanctuary, every injection is recommended only after a comprehensive assessment. Our aim is not simply to perform procedures, but to help you choose the treatment most likely to benefit your individual condition.
Injection treatments are usually considered when pain is coming from a specific structure or nerve, simpler treatments have not provided enough relief, reducing pain would help you participate in rehabilitation, or an injection may help confirm the source of your pain. The decision is always made together, based on your symptoms, examination findings and any relevant imaging.
Different injections work in different ways. Some reduce inflammation. Some temporarily numb a painful structure to confirm the diagnosis. Others interrupt pain signals carried by nerves. Many procedures combine diagnosis and treatment, helping us better understand your pain while aiming to improve your symptoms.
Lumbar medial branch blocks
Medial branch blocks help diagnose pain arising from the small facet joints at the back of the spine. Local anaesthetic is placed around the tiny nerves supplying these joints. Significant short-term relief suggests the facet joints may be the pain source and may indicate that radiofrequency denervation could provide longer-lasting benefit.
May help with mechanical low back pain, pain worse when standing or walking, pain eased by sitting, and facet joint arthritis.
Radiofrequency denervation
If medial branch blocks provide good temporary relief, radiofrequency denervation may be considered. Heat generated by radiofrequency energy temporarily interrupts the tiny nerves carrying pain from the facet joints. Pain relief often lasts 6–18 months, although this varies between individuals.
May help with chronic lumbar facet joint pain and selected neck facet joint pain.
Sacroiliac joint injections
The sacroiliac joints connect the spine to the pelvis. These joints can become painful following injury, pregnancy, arthritis or altered movement patterns. Injection of local anaesthetic and steroid into the joint may reduce pain and inflammation.
May help with buttock pain, pain after pregnancy, pain worse on stairs, and sacroiliac joint dysfunction.
Nerve root blocks
A nerve root block delivers local anaesthetic and corticosteroid around an irritated spinal nerve. It is commonly used for sciatica, cervical or lumbar radiculopathy, and pain caused by disc prolapse or spinal narrowing. The aim is to reduce nerve inflammation and create an opportunity for natural recovery and rehabilitation.
Caudal epidural injection
A caudal epidural places medication into the epidural space through the natural opening at the base of the spine. The medication spreads around irritated nerves and inflamed tissues, and may be considered for sciatica, multiple irritated lumbar nerve roots, spinal stenosis, or selected cases of persistent pain after spinal surgery.
Peripheral nerve blocks
Peripheral nerve blocks place local anaesthetic, and sometimes steroid, around a specific nerve outside the spine. Examples include ilioinguinal, genicular, pudendal, intercostal, lateral femoral cutaneous and abdominal wall nerve blocks. They are particularly valuable for persistent pain after surgery and certain nerve injuries.
Occipital nerve blocks
The greater and lesser occipital nerves supply sensation to the back of the scalp. Occipital nerve blocks may help pain caused by irritation of these nerves, including occipital neuralgia, cervicogenic headache, some migraine disorders and persistent headache following neck injury.
Trigger point injections
Trigger points are tight, sensitive areas within muscles that can produce local and referred pain. Injection with local anaesthetic helps relax the muscle and reduce pain. They are usually combined with stretching, physiotherapy and movement rehabilitation.
Most procedures are performed using a fine needle and local anaesthetic. Some discomfort is unavoidable, but procedures are generally well tolerated. Many patients describe the injection itself as less uncomfortable than they expected.
Usually not. Injection treatments are one part of a broader pain management plan. For the best results they are often combined with exercise, physiotherapy, lifestyle medicine, medication optimisation, pain education and improving sleep and general health.
All medical procedures carry some risk. Serious complications are uncommon, but may include bleeding, infection, temporary numbness or weakness, allergic reactions, or failure to improve symptoms. Steroid injections also carry additional considerations, including temporary changes in blood sugar levels, facial flushing and short-term suppression of the immune system.
At Wye Sanctuary, injection treatments are performed using imaging guidance whenever appropriate. Depending on the procedure, this may involve ultrasound guidance or X-ray guidance. Using imaging improves accuracy, helps place medication precisely where it is needed and reduces the risk of complications.
Injection treatments are most effective when they are used as part of a thoughtful, personalised treatment plan rather than as isolated procedures. As a Consultant in Pain Medicine and Anaesthesia, Dr Charlotte Small performs a wide range of image-guided interventions using both ultrasound and fluoroscopy. Every recommendation is based on a careful assessment of your symptoms, examination findings and goals, with the aim of choosing the procedure most likely to support your recovery.
Will I have sedation?
Most injection treatments are performed using local anaesthetic only. Sedation is rarely necessary, as it can make procedures less safe and may reduce the accuracy of diagnostic injections.
How quickly will I notice a benefit?
Local anaesthetic often works within minutes. If steroid is used, any benefit usually develops over several days and may continue to improve over two to four weeks.
How long do injections last?
The duration of benefit varies depending on the condition and type of injection. Some people experience relief for weeks, others for many months. Unfortunately, no treatment can guarantee a particular outcome.
Can injections be repeated?
Sometimes. The decision depends on how much benefit you experienced, how long it lasted and whether repeating the procedure is supported by current evidence and clinical guidelines.
What if an injection doesn’t help?
A lack of response can be valuable information. It may suggest that the pain is arising from a different structure, allowing us to refine the diagnosis and consider alternative treatment options.
“One of the biggest misconceptions about injections is that they are a ‘last resort’ or a cure for chronic pain. In reality, they are simply one tool among many. The most important decision is not how to perform an injection—it’s whether an injection is the right treatment in the first place. My role is to ensure that any procedure we recommend has a clear purpose and fits within a personalised plan designed to help you move, function and live better.”