Treatments

Injections placed where they need to go.

An injection is only as good as its placement. Everything here is done under live X-ray or real-time ultrasound so the medication reaches the structure we identified — not the general area.

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Why guidance matters

Studies of unguided injections into deep structures — the hip joint, the sacroiliac joint, the shoulder — consistently find that a significant share miss their target. A missed injection does more than fail to help. It produces a false negative: the patient and the physician conclude the structure was not the problem, when in fact it never received the medication.

Everything in this practice is placed under image guidance for that reason. Live X-ray for spine work, where contrast confirms the medication is spreading where it should before anything else is given. Real-time ultrasound for joints and soft tissue, where the needle is watched into position.

Injections we perform

Epidural steroid injection

For nerve root pain from a disc or stenosis. Delivered by interlaminar, transforaminal or caudal approach depending on the anatomy involved.

Details

Medial branch block

Numbs the small nerves supplying a facet joint. Primarily diagnostic — a positive response is what qualifies you for radiofrequency ablation.

Details

Facet joint injection

Directly into the arthritic joint at the back of the spine, for facet-mediated back or neck pain.

Sacroiliac joint injection

Diagnostic and therapeutic for pain low and to one side, frequently mistaken for hip or lower back pain.

Large joint injections

Knee, hip and shoulder under ultrasound — steroid or hyaluronic acid depending on the joint and the stage.

Peripheral nerve blocks

Targeted at a specific nerve producing pain, including occipital nerve blocks for headache arising in the neck.

Bursa and tendon sheath injections

Subacromial, trochanteric and other bursae, placed under ultrasound.

Trigger point injections

For myofascial pain layered on top of a structural problem.

How it works

What an injection appointment involves.

  1. 01

    Before

    Most injections need no special preparation. Tell us about blood thinners well in advance — some need to be held. You will not need a driver for most procedures; we will tell you if yours is an exception.

  2. 02

    The procedure

    You are positioned on the procedure table, the skin is cleaned and numbed, and the needle is guided into place under imaging. Most injections take a few minutes. You are awake and can talk to Dr. Loch throughout.

  3. 03

    Immediately after

    A short observation period, then home. Local anaesthetic in the injection often relieves the pain for a few hours — a useful diagnostic signal, so we will ask you to note it.

  4. 04

    The following days

    Steroid takes several days to a couple of weeks to reach full effect. Some soreness at the injection site in the first day or two is normal. We follow up to see what actually happened.

In their words

Patients on their injections

5.0 from 217 Google reviews
★★★★★
Great doctor who listens and cares. Highly recommend his office for back related injections that are needed.
Cade Funderburk
★★★★★
Dr Loch is extremely dedicated to his Patients needs. He asks about the results of the prior spinal injections,, and then modifies the next treatment, resulting in a better pain management outcome. I’m now also going to have Dr. Loch take care of my rotator cuff issues. Nice office, staff and Dr.
Vincent Criscillo
★★★★★
Dr. Loch and his team were incredible with me. I had been suffering from pain for a year, being treated solely for muscle aches. I arrived at the clinic with my body visibly misaligned and in severe pain—having gone days without sleep despite taking the painkillers and muscle relaxants my primary care providers had prescribed, as they refused to give me a referral to a specialist or order any diagnostic tests. When I got to this clinic, they wouldn't let me go another day without a pain-free night's sleep. They ordered an MRI, and by 5:00 PM, the doctor was already seeing me; he administered an injection in my head and prescribed medication, as my condition also involves my nerves. I am so grateful to have found this clinic and these people who truly cared about my condition. I am finally receiving the proper treatment. I am deeply grateful.
Josiane Jefremovas
Read all reviews on Google → Synced from Google on 24 July 2026

Common questions

Does it hurt?
The skin and deeper tissue are numbed first, so most people describe pressure rather than pain. Spine injections are generally better tolerated than patients expect.
Will I be sedated?
Most injections are done with local anaesthetic only, which keeps you able to give feedback during the procedure — that feedback is diagnostically useful. Sedation is available where a procedure warrants it.
How soon will I know if it worked?
The local anaesthetic tells you something within hours. The steroid effect builds over several days to two weeks. We ask patients to keep track of both, because they answer different questions.
How many can I have?
There is no fixed number, but repeated steroid is not harmless and we do not schedule injections routinely. If you are needing a third injection in the same place, the plan deserves rethinking rather than repeating.
Are these covered by insurance?
Most are, subject to your plan and often to prior authorisation. We verify benefits and can give you an estimate before scheduling. See the insurance and cost page.

Eliminate pain and reclaim your life.

Request an appointment with Dr. Loch, or call the office at (904) 750-3787. Most patients are seen within a week.

Request an appointment