Guided Spinal Injections

These procedures involve injection of steroid type chemicals close to spinal nerves (nerve root injections) or the space around the spinal cord (epidurals). The Radiologist positions the needle by viewing on CT scanner into the right spot.

 

I thought I’d share what one of Melbourne’s best spinal surgeons told me about them (as he referred me for one!)

 

He told me in his experience for people he referred to have nerve root injection, approximately 60% described some effect from the injection. More specifically though, roughly 20% of people felt good improvement, 20% fair and 20% slight. 

 

Not great numbers I think you’ll agree, but probably worth a try for unbearable or unchanging leg pain if your doctor thinks so.

 

He also said that he felt epidural injections were a “shot in the dark”.

 

In more general conversation I’m glad he agreed with me that increased back pain first thing in the morning is a key sign for non-invasive treatment. Simply put, more pain in the morning is most likely due to back joints getting stiffer overnight. This is good for someone like me, because stiff joints will usually respond to appropriate manual therapy which I can provide.

 

So even if your CT or MRI is awful, if you are worse in the morning it is worth trying some (manual) Physiotherapy. You should get some improvement.

SIDE HIP PAIN

July 1, 2025
Pain on the side of the hip from bursitis or gluteal tendon inflammation is an annoying problem often more so at night because lying on it frequently disturbs people’s sleep. It is a reasonably common problem for me to see. Tendons and bursae degenerate as we age and weakness in hip musculature can be a cause. But it can happen to anyone. Guided steroid injections can help, but most people respond well to soft tissue manipulation. The lower back should definitely be assessed and (usually) treated manually as related spinal joint stiffness frequently contributes to the issue. The hip joint should also be assessed and treated if necessary. Exercises can be helpful but need to match the pathology so an Ultrasound image might be needed give a diagnosis.

IRONMAN

June 1, 2025
Interstate visitor Client D came in two days before the Melbourne Ironman. Despite treatment interstate he had persisting leg soreness which had stopped him running for a week and had serious doubts on finishing, let alone doing well enough to earn him what he entered for: a qualifying position in the Hawaiian Ironman. He had some back joint stiffness and lateral hamstring trigger point muscle spasm and after loosening these up he felt better. However running a full marathon after the 3.8 kilometre swim and 180 kilometre cycle would be a massive test! The news post race was that he had got though the event and even with a puncture on the cycle grabbed a spot in Hawaii!  Well done to him! (And a bit to me too!)