Sometimes doctors use injections or implanted devices to deliver pain relief medication locally instead of using oral pain drugs. Some implanted devices don’t deliver medication, but instead use other techniques for pain relief.

Doctors may give several different types of injections for back pain. The best one for you, should you need one, will depend on your particular problem. These injections include:

• Epidural steroid injections. When inflammation within the spinal column causes nerve-root irritation and swelling, doctors sometimes administer a potent anti-inflammatory medication to reduce inflammation and ease pain. Steroids typically are injected directly into the epidural space – the area between the dura mater and the vertebrae – to deliver pain-relieving medication directly to the site of inflammation. Pain relief typically begins in less than a week and lasts anywhere from several days to a few months.

• Selective nerve-root block. When a nerve root is compressed or inflamed, it can cause pain in the back and leg. A selective nerve-root block is an injection of a steroid and/or numbing agent into the area of the nerve where it exits the spinal column between the vertebrae. Pain relief begins within a few days to a week and may last up to a few months.

• Facet joint block. If your doctor suspects the source of your pain is in the facet joints, where the vertebrae connect to one another, she may recommend a procedure called a facet joint block. In this procedure, a steroid and/or anesthetic medication is injected directly into the joint capsule. Pain relief may last several weeks or months.

• Facet neurotomy. A facet neurotomy is a procedure used in people for whom a facet joint block has suggested that a particular joint is a cause of back pain. This procedure uses a heated needle to burn and disable the nerve responsible for the pain. Although the nerve usually grows back, allowing pain to return, this can take several months to a year.

• Sacroiliac joint block. Sacroiliac joint blocks involve injecting an anesthetic or anti-inflammatory medication into the sacroiliac joint, which connects the sacrum (one of the sections of the spine, composed of five fused vertebrae) to the pelvis. These may be used to relieve low back pain that results from inflammation or damage within the sacroiliac joint.