At Dorset Pain Clinic, the procedure sits within a wider journey: clinical assessment, relevant imaging, explanation of alternatives, treatment only when appropriate, and rehabilitation afterwards when useful.
What image guidance does, which spinal injections may be appropriate, and why the diagnosis matters more than the needle.
Consultant Radiologist and Interventional Pain Specialist • Updated 16 September 2026
Image guidance helps the clinician place a needle accurately at the intended spinal target. But the important question comes before the procedure: is there a clear diagnosis and a good clinical reason to inject that particular structure?
Fluoroscopy provides real-time X-ray guidance during many spinal procedures. It helps confirm anatomical landmarks and needle position. Contrast may also be used in some procedures to confirm placement before medication is delivered.
Different procedures have different purposes. Epidural or nerve-root approaches may be considered for selected nerve-related pain. Medial branch blocks are diagnostic procedures used in selected people with suspected facet-related pain before considering radiofrequency treatment. There is no single injection that is appropriate for all back pain.
Accurate needle placement does not guarantee that a treatment will work. If the pain generator is wrong, even a technically perfect injection may not help. This is why assessment, imaging review and consent are central to the pathway.
At Dorset Pain Clinic, the procedure sits within a wider journey: clinical assessment, relevant imaging, explanation of alternatives, treatment only when appropriate, and rehabilitation afterwards when useful.
Our model combines senior clinical assessment, specialist imaging, pain medicine, targeted intervention and rehabilitation. The aim is to reduce fragmentation, avoid unnecessary duplicated steps and give you a clearer plan.
Combines diagnostic imaging expertise with image-guided musculoskeletal and spinal intervention, linking symptoms, examination and imaging before deciding whether a procedure is appropriate.
Provides senior specialist assessment of persistent and complex pain, medication review and personalised treatment planning, with extensive experience in interventional pain medicine.
NICE advises against spinal injections for non-specific low back pain.
NICE says epidural local anaesthetic and steroid can be considered for acute and severe sciatica in selected patients.
It is a diagnostic block of nerves supplying the facet joints, used in selected patients before radiofrequency denervation is considered.
This article is general information and does not replace an individual medical assessment.
If pain is affecting your sleep, work, mobility or confidence, a specialist assessment can help clarify what is happening and what the sensible next step should be.
