Infiltration Therapy for Back Pain

Infiltration Therapy for Back and Joint Pain

Pain in the spine or joints can have various causes. If conservative measures alone are not sufficient, targeted infiltration therapy may be a treatment option. In this procedure, medications or other appropriate substances are delivered directly to the structure causing the pain.

At the ROC in Aschheim near Munich, we perform image-guided injections. Using ultrasound, we can visualize the relevant anatomical structures and precisely target the injection—without the radiation exposure associated with a CT-guided injection.

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Infiltration Therapy at a Glance

Targeted treatment of the affected structure
Image-Guided Procedure Using Ultrasound
No radiation exposure from CT scans or X-rays
Outpatient Treatment
Short treatment duration
Individual selection of the substances used
Can be used for various spinal and joint conditions
Can be used for diagnostic and therapeutic purposes

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What is infiltration therapy?

In infiltration therapy, medications or other therapeutic substances are injected directly into the area surrounding a structure that is causing pain. Unlike systemic medication, this treatment is administered directly at the site of the condition.

Depending on the cause of the symptoms, the injection may be administered, for example, into a facet joint, an irritated nerve root, or an affected joint.

The type of injection that is appropriate and the substances used depend on the diagnosis, symptoms, and individual findings.

When might infiltration therapy be appropriate?

Infiltrations are particularly appropriate when the cause of the symptoms can be attributed to a specific anatomical structure.

Possible applications include, among others:

Facet Syndrome
Facet Joint Osteoarthritis
Herniated Disc
Disc Protrusion
irritated nerve roots
Spinal Canal Stenosis
Neuroforamen stenosis
Localized back pain
radiating pain in the arm or leg
certain painful joint conditions

Therefore, a thorough diagnostic evaluation is performed before any infiltration. What matters is not just where the pain is felt, but which structure is likely causing it.

What types of infiltration therapies are available?

Depending on the cause and location of the symptoms, various infiltration techniques are available.

Facet Joint Injection

Periradicular Therapy (PRT)

Infiltrations in Joints

What substances are used in an infiltration?

The choice of substance depends on the specific condition and the treatment goal.

Local Anesthetics

Local anesthetics can be used to temporarily reduce pain transmission. They can also be helpful for diagnostic purposes: If symptoms subside significantly following a targeted infiltration, this may indicate that the treated structure is indeed involved in the origin of the pain.

Anti-inflammatory medications

In cases of inflammatory irritation, anti-inflammatory medications may be used depending on the indication. The decision on whether to use a medication—and which one—is made on a case-by-case basis.

PRP / Autologous Blood Plasma

For certain orthopedic conditions , the body’s own blood plasma—Platelet-Rich Plasma (PRP) —can also be used. To do this, a small amount of blood is drawn and processed to obtain concentrated plasma for treatment.

Hyaluronic acid

Hyaluronic acid can be administered as an injection for certain degenerative joint diseases. Whether treatment is appropriate depends, among other things, on the affected joint and the individual findings.

Ultrasound-Guided Infiltration in the ROC

During an infiltration, the precise placement of the needle is crucial. That is why we perform these procedures at the ROC under imaging guidance.

Using ultrasound, we can visualize anatomical structures in real time and monitor the needle's position during treatment.

Another advantage over CT or X-ray-guided procedures is that ultrasound does not use ionizing radiation.

However, the type of imaging that is appropriate for a specific infiltration depends on the target structure and the individual’s anatomical situation.

How does infiltration therapy work?

1. Examination and Diagnosis

Before treatment, we first determine the cause of the symptoms. In addition to a physical examination, diagnostic imaging may be necessary, depending on the specific issue.

At the ROC, one of the facilities available for this purpose is an open MRI scanner located directly on the Aschheim campus.

2. Planning the Infiltration

Based on the diagnosis, we determine which structure to treat and discuss with you which infiltration technique is appropriate.

The choice of substance used is also made on an individual basis.

3. Ultrasound-Guided Injection

The affected area is first disinfected. The needle is then guided under ultrasound guidance to the desired structure, and the intended substance is injected.

4. After Treatment

After the injection, you will remain with us for a short time for follow-up. Depending on the treatment performed, you will receive personalized recommendations regarding physical activity and post-procedure care.

How quickly does an infiltration take effect?

When and to what extent an effect occurs depends on the cause of the symptoms, the structure being treated, and the substance used.

A local anesthetic can take effect very quickly. With other substances, it may take longer for any therapeutic effect to become apparent.

Furthermore, an infiltration does not provide sufficient or lasting relief of symptoms for all patients. For this reason, we view it as part of an individualized treatment plan rather than a one-size-fits-all solution for back pain.

Infiltration or Denervation for Facet Joint Pain?

In cases of symptoms originating in the facet joints, a targeted injection can also provide diagnostic information. If targeted treatment of a specific structure results in significant temporary pain relief, this can be taken into account when planning further therapy.

If facet joint pain persists for an extended period, additional treatment options may be discussed depending on the findings.

This includes, for example, facet denervation. In this procedure, the small nerves that transmit pain signals from the affected facet joints are specifically treated.

Advantages of Ultrasound-Guided Infiltration

Precise Treatment

The target structure and the position of the needle can be visualized using ultrasound during the procedure.

No radiation exposure

Unlike CT- or X-ray-guided infiltration, ultrasound does not involve ionizing radiation.

Outpatient Treatment

The treatment can be performed on an outpatient basis at the ROC in Aschheim, near Munich.

Personalized Treatment Plan

We determine which type of infiltration is appropriate based on the individual findings.

Infiltration Therapy at the ROC in Aschheim, near Munich

For back and joint pain, the ROC first focuses on establishing an accurate diagnosis. This is because an injection is particularly effective when the structure causing the pain can be identified as precisely as possible.

To this end, we combine orthopedic examinations, modern imaging, and ultrasound-guided procedures all under one roof.

Depending on the findings, the injection may be used as a standalone treatment or as part of a more comprehensive treatment plan. If necessary, additional conservative, physical therapy, or regenerative procedures may be added.