Intradiscal Injections

Discogenic low back pain is a major concern for most people. It is the most common cause of low back pain (LBP). Amazingly, until the late 1980’s the discs were thought to not have sensation and thus could not cause pain. We learned that the outer surface is very well innervated and yes definitely can cause pain. In fact, now it is the most common cause of LBP. The gold standard has always been a discectomy for the treatment of disc pain but recently certain injections have been available for the treatment of disc related pain. These include; a mixture of glucosamine/chondroitin/dextrose, Ozone gas, and Melthylene blue. The success rates with these injections are around 50 to 60% effective. That means that 50 to 60% of those treated get some significant improvement with the injection. We have performed all of these and in my experience, the success rate is around 50%. We have seen better results with the Glucosamine mixture than the other two but if one type of injection fails, we have seen success with the others. The Glucosamine mixture had a published success rate of around 60% which is close to what we see. The Ozone gas was developed by an Italian team and the success rate they published was near 90% effective. We have utilize this for years and at best we feel it is a 50% success rate. As for the methylene blue, which is a dye, the published rates were around 80% by a Chinese team but we need another year to see what our long term results are. Nonetheless, these are excellent options to consider prior to surgery since they don’t involve anything more than a needle. Also, it is important to remember that the success rates of spine surgery are around 70% which isn’t must greater than these injections.

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