Elite Spine

Targeted Injection Therapy

You have nerves that run from your spinal cord outwards to your neck, back and legs. When one of these nerve “roots” (the end closest to your spinal cord) become irritated or inflamed due to a damaged disc or other condition, it can cause arm pain, back pain and/or leg pain.

A targeted injection therapy can help reduce the inflammation and alleviate the pain when other conservative pain management methods have failed to fully resolve your symptoms. A targeted injection therapy may be right for you if your back pain has lasted longer than four weeks, is severe, or has not improved with other treatments, such as physical therapy.

At Elite Spine, there are many different types of targeted injection therapies which we may tailor to your individual needs. Your suitability for each type of injection will be discussed and planned with you on your consultation. The majority of our patients do extremely well and experience significant relief of pain and suffering following appropriately prescribed spinal injections. Sometimes injections may need to be repeated or a different type of injection may need to be performed, once your symptoms are better localised and controlled.

At Elite Spine, the decision to perform additional injections is made only after careful observation and follow up. We usually do not prescribe a series of injections.

As with all treatments, there are some risks associated with spinal injections that will need to be considered before proceeding. These risks include a small chance of bleeding, infection or injury to local nerves or vessels near the targeted site. It is extremely important that you let us know if you are taking any anti-inflammatory, blood thinning and/or herbal medications that may increase your risk of bleeding during and immediately after the procedure. Many of these medications will need to be temporarily discontinued for the week preceding the injection to decrease the risk of bleeding.

While there are many variations of targeted injection therapies available, we have listed below an overview of our most frequently used injection therapies.

Specific Therapies

Selective Nerve Root Block

A selective nerve root block procedure is an injection of a small amount of steroid and local anaesthetic around a specific nerve root, or spinal nerve, which exits from the spinal cord.

Selective Nerve Root Blocks can be done in the cervical (neck), thoracic (chest) and lumbar (lower back) regions. This type of targeted injection procedure may be chosen for you for both therapeutic (pain relieving) and diagnostic (identifying the nerve responsible for your pain) purposes.

Caudal Epidural Injection

A caudal epidural is an injection into the lowest portion of the epidural space. A caudal steroid injection can help reduce lower back and leg pain caused by sciatica, herniated discs, bone spurs or other back problems.

The steroid medication is injected into your back, into the area between the membrane that contains the spinal fluid (the dura) and the thickest ligament between your vertebrae.

Facet Joint Injection/Facet Block

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back.

A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anaesthetic (numbing agent) and/or steroid medication, which can anaesthetise the facet joints and block the pain receptors. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

Sacroiliac Joint Injection

The sacroiliac (SI) joint is a strong weight bearing joint in the pelvis that connects the sacrum and pelvis. There are two joints, one on each side of the sacrum, reinforced by ligaments. Both joints normally have movement and provide shock absorption for the spine. Just like other joints in the body, this joint can become inflamed, unstable and dysfunctional. Localized steroid injections into the SI joint can provide targeted therapy to reduce pain and inflammation and allow physical therapy to make further progress.

Other Targeted Injection Therapies

Occasionally, it may be decided that a different type of targeted injection therapy would be more suitable for an individual patient’s needs. This will be discussed and explained at your consultation.

Contact Us

If you wish book an appointment you can get in touch with us as listed below.

Monday - Friday: 08:00 - 16:00
Saturday - Sunday : Closed
St. Raphael's House
81 - 84 Dorset Street Upper
Dublin 1
The Gables
Torquay Road, Foxrock Village
Dublin 18

Patient Testimonials

Elite Spine

I was recently referred to Elite Spine by my local G.P. as I had severe pain in my lower back and right hip. From the moment I arrived at the hospital door I was treated in a most professional and caring manner by the full team at Elite Spine. Diagnosis and treatment was swift and most professional. I am now fully recovered, pain free and leading a normal life again. Thank you Elite Spine. FMcG


From the time where my health began to be significantly impacted - the speed, efficiency and professionalism of Mr.Butler and his team was exceptional. From my doctors initial referral to Mr. Butlers clinic, Conor McBride, Mr. Butlers executive assistant did everything he could to work my hectic work diary around Clinic times, while Clinical Nurse Specialist Andrea was on hand post op to deal with all worries and queries. It's a great relief to know that your interests are what matters when life throws you a serious curve-ball.


Had a recurring, (over two years), back problem and on attending the Mater Private Hospital requested that remedial attention, if necessary, should be undertaken by Mr Joseph Butler. He was strongly recommended to me by a Health Professional who knew of his acknowledged expertise. Upon diagnosis I had, some two days later, a Lumbar Decompression and was up and about (timidly) the following day. I can strongly reccomend Mr Butler and his Clinical Nurse Specialist Andrea Flannery fortheir expert and "down to earth" approach.


During the past year I experienced severe neck and arm pain. I was referred to Mr Butler from my GP. Having a background in the medical field I was very apprehensive when surgery was suggested as the long term answer. I met with Mr butler and Nurse Andrea. They calmed my fears. When I arrived at the Mater Private I was welcomed by them. In surgery I was wheeled in and both were there. What a sense of safety!. My recovery went excellent and they were there for me daily. My recovery was fast and straightforward. They are at the other side of the phone if I need them, Thankfully I haven’t. If one could say it was a good experience, then it was excellent.

Sr McG

I was fortunate to be referred quite quickly to Mr Butler but in advance of my first consultation, I had spoken with the Elite Spine Team on the phone, they were very reassuring and once my condition was diagnosed and the date set for surgery, I felt a certain degree of relief. After surgery, it was wonderful to be pain free. To be able to sleep uninterrupted is like winning the health lotto. The care received from the entire team was fantastic."


Earlier this year my husband suffered from a very severe back condition. On arrival at Elite Spine Clinic we were treated with the utmost kindness and reassurance. The team of Mr.Joseph Butler, Consultant Spine Surgeon, Andrea,Spine Clinical Nurse Specialist,and Conor were each available to us at all times and we can’t thank them enough for the quality of care he received which was always professional and administered with great kindness.


Having endured and ignored a disc problem in my neck for many years I finally decided that the time had come to address the issue. Mr. Butler of Elite Spine was recommended to me and after an initial consultation, he recommended I have surgery but psychologically I wasn’t ready. At no time did he pressure me to take his advice. Eventually I had to accept that I needed to heed his recommendation. From my initial consultation to my final consultation I found Mr. Bulter to be quietly reassuring and extremely diligent. I met with his specialist nurse who continues to this day to follow up on my progress. At all times I felt I was in competent and capable hands. I cannot recommend Elite Spine highly enough and I am a very fussy ex-nurse!!