The ‘Two-Pin’ technique increases sanitation for multiple dose vial users. They draw with the first pin, and then shoot/inject into the body with a new one. This procedure prevents any residual contaminants that may have remained on the drawing pin from being transferred into the body via the injection site. It also makes injection less painful since the drawing needle is necessarily dulled during passage through the rubber stopper atop the vial. A dulled needle increases injection pain because it doesn’t pierce the body as cleanly as an unused one. The protocol below is followed by AAS users who draw from multiple dose vials, but steps 4 - 8 are routinely disregarded by those users who draw from ampoules (also called ampules) and sachets.
Steroids are used to fight inflammation and speed healing. For injuries, this treatment may be a good idea, but for most back pain scenarios, I always ask, where is the inflammation? As Dr. Sarno has pointed out time and time again, there is rarely evidence of any inflammatory process in the majority of chronic pain complaints. Even in cases where inflammation exists, steroids are not a very good option, since they are often completely ineffectual or only provide short term benefits, sometimes only due to the placebo effect.
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.