Lumbar disc herniation is a common health problem affecting many people today. A sedentary lifestyle and heavy workloads especially trigger this condition. Poor sitting habits also increase the risk of lumbar disc herniation. Patients usually visit the doctor complaining of pain in the lower back and legs. These pains can sometimes worsen with actions like coughing or sneezing. There are various treatment methods for lumbar disc herniation. Injection therapy stands out as an effective option among these. Additionally, physical therapy and behavioral therapies support the treatment.
However, in patients who are morbidly obese, have severe spinal canal stenosis, or very advanced spondylolisthesis, its effectiveness is lower and the duration of relief may be shorter; still, if surgery is not an option, it remains the most effective method for pain reduction.
Prof. Dr. Özgür KILIÇKESMEZ
Interventional Radiology / Interventional Neuroradiology
What Is Injection (Targeted) Therapy in Lumbar Disc Herniation?
In this method, the damaged nerves causing pain are targeted directly. The treatment is applied to specific nerve roots—those affected by stress on the spinal discs. Injection therapy reduces inflammation and edema and provides pain control. The procedure is performed with a fine needle and applied directly to the affected area.
The medications used during injection therapy are:
- Steroid: Reduces inflammation and edema, relieving pain.
- Ozone: Increases tissue oxygenation, speeding up healing.
- Anesthetic drugs: Temporarily block pain and provide relief.
Transforaminal epidural injections are preferred especially for severe pain caused by lumbar disc herniation. In this method, medications are injected around the nerve root to reduce the pressure caused by the herniation. The treatment aims to eliminate nerve root compression and yields effective results in suitable patients.
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Why Is Injection Therapy Used in Lumbar Disc Herniation?
Injection therapy for lumbar disc herniation is especially chosen for challenging cases. The treatment is usually applied to patients whose postoperative recovery has been unsuccessful. It offers a solution for pain that persists after surgery. Injection therapy is also recommended for certain physical conditions:
- Formation of inflammation and edema
- Spinal canal stenosis
- Facet joint disorders
This treatment has the potential to provide rapid pain relief. Depending on the patient’s overall health, injection therapy can be repeated at intervals—typically up to three times within one month. Most patients experience significant pain reduction after treatment. As pain decreases, they may notice improvements in fatigue, muscle weakness, and numbness. However, it is important not to return to normal activities immediately after treatment. Patients need adequate rest to observe the treatment’s effects and support their bodies’ healing processes. Rest during this period is critical for treatment success.
Who Is Injection Therapy for in Lumbar Disc Herniation?
Injection therapy for lumbar disc herniation is particularly suitable for patients with specific disease conditions. It is appropriate for those with early-stage herniation or advanced herniation problems. This treatment is effective in reducing edema and inflammation, relieving nerve root pressure, and eliminating local tissue irritation around the disc.
Patients eligible for lumbar disc herniation injection therapy include:
- Those with early-stage herniation
- Those with advanced herniation; discs that have ruptured or fragmented
- Patients with spinal canal narrowing
Because injection therapy has few side effects, it is suitable for many patients. It is recommended based on the patient’s current health status and potential to respond to treatment. Early initiation combined with medications and physical therapy accelerates recovery and yields more effective results. This comprehensive approach plays an important role in lumbar disc herniation treatment. The direct intervention around the disc helps heal surrounding tissues and significantly reduces the patient’s pain.
How Is Injection Therapy Performed in Lumbar Disc Herniation?
Injection therapies used in lumbar disc herniation treatment act directly on the affected nerves. This method plays a key role in pain control and reducing inflammation. For pain caused by lumbar disc herniation, epidural injections can be applied with three different techniques:
- Caudal block: Injection at the sacral hiatus under ultrasound or radiologic guidance.
- Midline lumbar injection: Preferred for canal stenosis and midline herniations.
- Selective nerve root injection (targeted therapy): Performed under fluoroscopic guidance directly into the nerve foramen.
The epidural injection procedure typically takes 15–20 minutes, with the patient usually in a prone position. After the procedure, the patient rests for 1–2 hours. This rest period is important to enhance treatment efficacy and minimize potential complications. Once the rest period is complete, the patient can usually be discharged the same day. This therapy method effectively relieves pain caused by lumbar disc herniation.
How Many Sessions Are Needed for Targeted Injection Therapy?
The number of sessions for targeted injection therapy in lumbar disc herniation varies based on multiple factors. Since each patient’s condition is unique, the treatment plan is personalized. The factors affecting treatment duration include:
- Type and stage of the disease: Treatment length depends on herniation size and location.
- Response to treatment: Patient responses determine continuation of therapy.
- Treatment method: Different techniques influence session count and duration.
- Overall health and other conditions: Patient health status and comorbidities affect planning.
- Treatment goals: Aimed at reducing pain severity, controlling pain, or improving function.
The treatment plan is customized by the physician based on patient evaluation and the factors listed above. The process may be short or span a longer period. Session duration and intervals are also adjusted to patient needs. Therefore, the exact number of sessions cannot be predetermined. Treatment progress and results are regularly assessed, and the plan is updated as needed.
Targeted Injection Therapy Prices 2025[/h2]
Factors affecting the cost of targeted injection therapy include the patient’s health status, the modernity of the technology used, and the treatment duration. The experience of the practitioner and the clinic’s location also influence pricing. Additionally, geographic region and whether the patient has private health insurance can cause price variations. These factors are considered when determining the cost of targeted injection therapy.Frequently Asked Questions
How long does targeted injection therapy take?
The duration of targeted injection therapy varies based on the patient’s condition and the number of levels treated. Typically, the procedure takes 10 to 30 minutes. The duration depends on the number of injections required. Thus, treating more levels may extend the time. However, in most cases, the process is quick, and patients are moved to a recovery area shortly after completion.
Is targeted injection therapy done at a single point?
If the pain source is at a single level, a single injection may suffice. However, if multiple pathologies or accompanying degenerative changes exist, injections at multiple points are required. Even for a single lesion, approaching and injecting around the lesion from several angles can greatly enhance treatment efficacy. It is important to note that the temporary mild discomfort felt during the procedure helps achieve much better outcomes.
Are patients sedated during targeted injection therapy?
No, patients are not sedated. Mild sedatives, analgesics, and local anesthesia are used. Patients must remain awake to describe the pain location and protect healthy tissues.
Who is targeted injection therapy for?
Targeted injection therapy is applied to patients with lumbar or cervical disc herniation who do not respond to physical therapy. Individuals whose daily quality of life is reduced by pain can also receive this treatment. Patients with recurrent herniation after surgery benefit from targeted injection therapy. This method is especially chosen for recurring pain. Therefore, it is directed at those experiencing various pain issues who have not sufficiently benefited from other treatments.
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
The duration of targeted injection therapy varies based on the patient’s condition and the number of levels treated. Typically, the procedure takes 10 to 30 minutes. The duration depends on the number of injections required. Thus, treating more levels may extend the time. However, in most cases, the process is quick, and patients are moved to a recovery area shortly after completion.
If the pain source is at a single level, a single injection may suffice. However, if multiple pathologies or accompanying degenerative changes exist, injections at multiple points are required. Even for a single lesion, approaching and injecting around the lesion from several angles can greatly enhance treatment efficacy. It is important to note that the temporary mild discomfort felt during the procedure helps achieve much better outcomes.
No, patients are not sedated. Mild sedatives, analgesics, and local anesthesia are used. Patients must remain awake to describe the pain location and protect healthy tissues.
Targeted injection therapy is applied to patients with lumbar or cervical disc herniation who do not respond to physical therapy. Individuals whose daily quality of life is reduced by pain can also receive this treatment. Patients with recurrent herniation after surgery benefit from targeted injection therapy. This method is especially chosen for recurring pain. Therefore, it is directed at those experiencing various pain issues who have not sufficiently benefited from other treatments.
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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