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Facet Injections vs. Epidural Injections

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Doctor injects epidural steroid injection into a patient's spine.

Chronic pain makes it hard for people to perform daily tasks. Although they’re typically caused by degenerative conditions, nerve problems, and spinal injuries, chronic pain can’t be solved without pinpointing its actual cause. Patients usually opt for facet joint injections and epidural steroid injections to help them deal with the pain.

So what’s the difference between the facet and epidural injections? Although both treatments are utilized for pain relief, they’re used for different underlying conditions. Epidural injections are for the back pain that radiates to the arm or legs. On the other hand, facet injections are injected into the facet joints for patients that suffer from degenerative conditions.

Facet Injections vs. Epidural Injections: What’s the Difference?

Around 16 million American adults suffer from chronic back pains that affect their daily routines. Chronic back pains are also the leading reason why many employees call in sick for their workdays. Patients who suffer from chronic back pains usually seek different treatments, such as medications and chiropractic care for pain management.

Other remedies for chronic back pains are facet joint injections and epidural steroid injections. Although both treatments are focused on pain management and relief, they work in different areas of the body and target different causes of chronic back pain.

Epidural Steroid Injections (ESI) have anti-inflammatory properties that treat pinched nerves caused by sciatica or spinal stenosis. They weren’t initially created to treat back pains, but rather minimize the pain felt in the thigh or buttocks due to inflamed nerves.

On the other hand, facet joint injections are either anesthetic or steroidal. They are a pain relief method that delivers medication to the spine through the specific joints connecting the vertebrae. The procedure is also used to diagnose the spinal problem. The main difference between utilizing facet injections for treatment or diagnosis is the site of injection.

A Closer Look Between Facet Injections vs. Epidural Injections

 Facet InjectionsEpidural Injections
What is it for?Treatment and diagnosis of different arthritic or degenerative conditions affecting the facet joints that don’t extend to the lower extremities.Treatment of sciatica (pain experienced from the lower back down to the legs) caused by degenerative changes or injury.
Where is it injected?Into very specific sets of joints and around facet joints (located between each level of the vertebra).Into the epidural space near the affected nerve.
How much does it cost?Around $1028 to $1898Around $112 to $1397

What is it for?

Facet injections are injected into a specific set of joints along the spine. They’re usually prescribed for patients diagnosed with chronic back pain caused by degenerative or arthritic injury or condition.

Facet joint injections also help diagnose a patient’s spinal problems, such as:

On the other hand, epidural steroid injections relieve inflammation of the nerves due to herniated discs or spinal stenosis. Herniated discs occur when the soft disks slip through the outer layer, causing the person to experience extreme pain or discomfort even at the slightest movement.

Spinal stenosis refers to the constriction of the spinal column that puts unnecessary pressure on the spinal cord. Patients diagnosed with this condition experience neck pain (cervical spinal stenosis) or lower back pain (lumbar spinal stenosis).

Both conditions cause patients to experience chronic back pain and sciatica, a condition that causes pain along the sciatic nerves that branch out from the lower back to the hips, buttocks, and legs.

How Does it Work?

During the facet joint injection procedure, the clinician puts the patient under local anesthesia. They use fluoroscopy to have a better view of where to inject the medication accurately. The anesthetic solution is injected into the joint or nerve branch to see if numbing the area relieves the pain.

If the first injection is successful, then the doctor has located the exact source of the symptoms. The physician then administers corticosteroids in the area to help with the pain for around 3 to 6 months. They might also perform a radiofrequency neurotomy that numbs the nerve even more for the patient’s relief.

The procedure for epidural steroid injection also starts with the application of a local anesthetic to the treatment area. This ensures that the patient is comfortable throughout the process. ESI also makes use of x-ray fluoroscopy to ensure that the medication is delivered accurately to the treatment site.

Once the needle is properly positioned, the corticosteroid medication is administered into the epidural space near the nerve roots. Depending on the location and severity of the pain, multiple injections might be required for the right and left sides. The procedure can be repeated in several spinal levels, depending on the doctor’s recommendation.

To ensure that both methods of pain management are safe and effective, the procedure must be done inside a doctor’s office or a hospital. The clinician might be accompanied by a radiologist to assist in the x-ray fluoroscopy.

Patient Qualification

Since facet injections and epidural injections target different causes of back pain, it’s best to consult a physician first to find out which procedure works better for your condition. Patients diagnosed with herniated discs, spinal stenosis, and sciatica should opt for epidural injections. Patients who experience chronic back pain because of  degenerative or arthritic conditions are better suited for facet injections.

Expected Results

Although they offer long-lasting pain relief from back pains, facet joint injections are not permanent. They typically only last for 3 to 6 months, so patients need to undergo another facet injection treatment to enjoy lasting results.

Aside from getting more facet injections every few months, another effective way to prolong its results is to opt for radiofrequency neurotomy. This procedure utilizes heat generated from the radiofrequency waves to block the pain signals from the affected joints and medial branch nerves.

On the other hand, patients experience relief within 3 to 7 days after their epidural steroid injection appointment. The effects usually last for several months. Most of them return home after the procedure and resume normal activities the next day.

If the pain starts coming back, it’s still safe for patients to receive additional treatment. However, they must consult with the physician immediately if they don’t experience any kind of relief after the procedure. This might be a sign that the pain is caused by other factors aside from the spinal nerves.

Possible Risks and Side Effects

All medical procedures come with certain risks. Both facet injections and epidural injections share the following side effects:

Although facet injections and epidural injections are generally safe, patients are still advised to contact their physician immediately once any of these symptoms show.

Get on the Road to Recovery with The Spine and Rehab Group

Here at The Spine and Rehab Group, our spine specialists are dedicated to providing safe and effective treatment and recovery plans for patients suffering from different spinal conditions. Our highly trained staff utilizes the latest tools and technology when performing epidural steroid injections and facet joint injections to ensure long-lasting pain relief for our patients.

Take the first step to your recovery with us here at The Spine and Rehab Group. Call us at (833) 847 – 7463 to schedule an appointment.

Read more: Is Increased Pain After Lumbar Epidural Steroid Injection Normal?

Page Updated on Jun 20, 2022 by Dr. Hosny (Interventional Spine Specialist) of The Spine & Rehab Group
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