Spinal and Musculoskeletal Injections

Spinal injections are performed either to confirm a suspected diagnosis or to reduce pain and inflammation resulting from spinal problems. These injections are performed under fluoroscopy by an interventional radiologist.

Several types of spinal injections are performed, including epidural steroid injections and facet-sacroiliac joint injections.

An epidural steroid injection is done to relieve pain caused by spinal degeneration, spinal stenosis (narrowing that exerts pressure on nerves), or disc herniation or protrusion. The steroid helps to relieve pain by reducing the inflammation. While some patients attain pain relief with a single injection, others may require multiple injections over a period of time.

Facet-sacroiliac joint injections also are prescribed to alleviate pain. The facet joints connect and stabilize the vertebrae, guiding and restricting movement of the spine. The sacroiliac joint, also known as the SI joint, connects the sacrum (the triangular bone at the bottom of the spine) to the pelvis. The steroid relieves pain by reducing the inflammation.

​What to Expect

You will lie on your stomach on a X-ray table. First, the region of your back requiring injection will be cleaned and prepped. The radiologist will then insert a small needle in the area and, guided by X-ray imaging, will inject a small amount of contrast material to confirm proper needle placement. Once confirmation is made, the radiologist will inject the medicine and remove the needle.

How to Prepare

When you schedule your appointment, we will inform you about any specific preparations depending upon the specific procedure your doctor has ordered. Please contact the Scheduling Department at 949/764-5573 if you have any questions.

Beginning several days before the procedure, you will need to discontinue certain medications.

  • If you are taking Plavix, Coumadin, Warfarin or Pradaxa, must stop 5-7 days prior to your procedure but you MUST check with prescribing physician first before stopping to see if your doctor has an alternative medication or instructions for you.
  • If you are taking Aspirin, Naprosyn, Ecotrin, Ibuprofen, Advil, Motrin, Aleve, Naproxen or Celebrex on a regular basis, we ask you to stop 5-7 days before your exam procedure but you MUST check with prescribing physician first before stopping to see if your doctor has an alternative medication or instructions for you.
  • If you take Lovenox, you must stop 12 hours before your procedure.
  • Stop taking fish oil, flax seed oil, vitamin E, 5 days prior to your procedure.

Please complete, print out and bring with you the following forms to your appointment:

  • Outpatient Medication Reconciliation form (for Breast Center and Interventional Procedures) - Download PDF

Discogram/Facet Cyst Aspirations

Please arrive 1 1/2 hours prior to procedure time. Preparation includes: Nothing to eat or drink after midnight or 6 hours prior to procedure except necessary medications with just enough water to swallow medication. You will be monitored for 4 to 6 hours after the procedure. You will need to have a driver to drive you home.

Spinal Epidural Steroid Injection, Nerve Root Blocks and Facet Blocks

Please arrive one hour prior to your procedure. Two hours prior to your procedure, drink clear fluids only. You must have a driver to drive you home.

Side Effects/Follow-Up Care

Side effects and complications

  • Possible complications include a small chance of infection or bleeding.
  • If the fluid space around the nerve in the spine is inadvertently entered during an epidural steroid injection, you may have a small chance of a post-procedure headache.
  • Occasionally, patients may describe pain in the area where the needle was placed, transient headaches or leg weakness.
  • Any of those symptoms should disappear within a few hours. If symptoms persist, please contact our office for further assistance.

Follow-up care

You will be advised to avoid strenuous activities for a certain time following the procedure. Do not drive until at least the next day.


Locations where NHRA provides Spinal and Musculoskeletal Injections services