If you have been involved in any type of accident causing an injury to your neck or back, you may reach a point in your treatment where you are recommended to get an injection. Usually, the recommendation is made by an MD or Orthopedic Surgeon and is the step after conservative treatment (physical therapy or chiropractic care). While injections are technically considered surgery, they are normally offered in an attempt to relieve pain and avoid more invasive forms of surgery. If you have been recommended for an injection, you will likely have questions about how exactly they work, the risks and how it will affect your personal injury case.
There are three general types of injection therapies-Trigger Point Injections (TPI), Facet Injections, and Epidural Steroid Injections (ESI).
Trigger Point Injections:
A muscle that was injured in an accident may contain trigger points or knots of muscle that do not relax. These trigger points can be painful and an injection into the area can cause the muscle to relax and alleviate pain. The knots are normally able to be felt from the surface of the skin and are considered to be minimally invasive. During a trigger point injection, a local anesthetic such as lidocaine or marcaine is used. Corticosteroids can also be used. While the relief may not be permanent, these injections are normally successful for these specific ailments.
Facet joints are hinges at the back of the spine that link the vertebrae together. They are what allow your back to be flexible and to bend and twist. Nerves run through these joints and when there is an injury to the area due to trauma from an accident, a facet block injection may be recommended. Facet injections serve a couple of functions. They can be used as a diagnostic tool to locate the source of pain as well to alleviate pain. A facet injection is administered using fluoroscopy to guide the needle into the facet joint capsule. The injection consists of a numbing agent and a steroid such as cortisone. The cortisone is time released in order to lengthen the effectiveness of the relief.
Epidural Steroid Injections:
The space outside of the sac of fluid surrounding your spinal cord is called the epidural space. An epidural steroid injection (ESI) is a method to deliver corticosteroid medication and numbing medication into the epidural space. The goal of these injections is to alleviate pain from a neck or back injury by reducing nerve inflammation. They are normally given in a series of three. An epidural steroid injection is not the same as an epidural that women may receive just before childbirth.
Risks and Reward:
While none of my clients begin their personal injury case looking for an injection, often the continued pain to the back or neck gets to the point where they are willing to try anything to get relief. Injections are safe, relatively painless and there is minimal risk. Even my clients who tell me they are afraid of needles tell me afterward that the procedure wasn’t bad. In fact, the only complication that one of my clients has experienced was an allergic reaction to the medication that cleared up within a couple of days. So, the overall pain and risk for the procedure is truly minimal.
As far as the effect of an injection on the value of a personal injury case, an insurance company will only put money on the procedure after it is done. While you may have had a recommendation for injection, an insurance company will assume that you will not follow through with the procedure. However, after an injection is performed, it always drastically increases the value of the case.
If you have questions about the effect of an injection on your personal injury case in Pinellas County or anywhere in the Tampa Bay area, I hope this article provided some helpful information.