Cortisone is a steroid. Cortisone is anti-inflammatory. In the context of spinal pain, a cortisone injection targets an area of your spine either thought to cause regional pain, or referred pain. The cortisone injections are done by highly trained and experienced radiologists who use imaging to guide precisely where the cortisone is injected. Despite the best efforts and intentions of everyone involved in your treatment cortisone injections do not always work.

While some patient report that injection of the inflamed area of their body is painful, others do not experience much pain at the time of the injection. Everyone will respond differently. The radiologist doing the procedure will first inject local anaesthetic before giving you the injection.

Most people tolerate the injections well with no adverse reactions. There are some risks involved with the injection. There is a small risk of introducing infection deep into your body. This is minimised by cleaning the area for injection with an antiseptic solution before doing the injection.

There is also a small risk of causing a bleed near the nerve that is being targeted. For that reason, it is important to stop any blood thinners as advised before your procedure. Please let your doctor know if you have a bleeding disorder.

Cortisone can build up in your body if you take it orally or have frequent injections. Your doctor will tell you what the maximum safe exposure is for you.

Nerve pain is generally sharp and shooting. Some people describe it as electric in nature. There are many causes for nerve pain; however, the most common reason is a pinched nerve in your spine causing pain radiating down your arm or leg.

It is best to treat this as soon as possible when it starts. You may be able to control it better, avoid needing “heavy” medications and prevent it becoming chronic.

The base level medication for this is regular Panadol and a non-steroidal anti-inflammatory if you can take the latter. Non-steroidal anti-inflammatories (abbreviated NSAIDS) include Neurofen, Brufen, Voltaren, Mobic and Celebrex. NSAIDS should always be taken after eating something. Some people are not able to take NSAIDs – you should always check with your doctor before starting this medication to make sure it is right for you.

You may then also need a nerve pain specific medication such as Lyrica, Amitriptyline or Neurontin. These are sophisticated medications, that will need a prescription. They all have some side effects and it is best to discuss this further with your doctor before taking the medications.

If you still have breakthrough pain despite these medications you should discuss the option of short-term opioid (morphine- related) medications. Your doctor will examine you and discuss with you if any further tests such as a CT or MRI are needed at this point.

When you are in severe pain, it is hard to imagine doing any exercise. Never-the-less it is important to keep moving. The spine is a complex set of highly specialised joints that keep you upright and mobile.

You do need to keep them moving to keep them functioning. The old adage “use it or lose it” hold true here.

The best thing at this point, is simple walking. Walking is something that everyone knows how to do. You do not have to have high expectations of long walks here. Multiple short walks are better.

Concentrate on engaging your core muscles, and walk at your own pace.

Your doctor will have arranged a scan for you and referred you for specialist advise. The following is general discussions and you will need your doctor to tell you which options are best for you.

In essence, there are three possible avenues open to you.

1. Pain medication +/- Physiotherapy

2. Nerve root block aka cortisone injection

3. Surgery – most commonly a microdiscectomy, however there are other possibilities depending on your specific condition.