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Epidural or Botox injection - which one?

For neck pain, specifically for chronic muscle pain...which is best and longer lasting?

I'm scheduled for an ESI this Fri for my cervical spine but am rethinking it. Maybe I should get a Botox injection instead.

Anyone have Botox and respond well?


  • dilaurodilauro ConnecticutPosts: 9,833
    personally, I would not do either. I would go with a series of Trigger point injections. They can do wonders in calming down some aggravated areas. ESI's are more disc related. The Trigger point injects lidocaine, so it numbs the area giving it time to rest a bit. But, listen to what your doctor tells you, I am just giving you my personal non-medical opinion.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • had botox every 6 weeks, she had a chronic spastic muscle that affected he ability to chew. She said it worked for that problem.
    I am not sure where your pain in your neck is, but I have had ESIs for neck pain extented from my neck to my shoulders with numbness down my arms. It works for about 6-8 weeks for me. Some people have said they don't have much benefit from them, maybe there problems are more muscle related than nerve related.
    I have had the trigger point injections and had an adverse reaction. I was in so much pain for 3 days, I won't do that again, There are some people that seemed to get relief from the trigger points, they are for myofascial pain and I guess the pain may be generated more from the muscles themselves. I find a myofascial massage much more beneficial for me/
    Everyone is different, that is why you have to be an advocate for yourself and keep records of your exact symptoms, why interventions were performed, any reaction to any intervention, any copies of any radiological findings and of course medication history, what helps, what doesn't, and any adverse effects. Good luck with your decision
  • Thanks to both of you for your feedback. I'm surprised that my question which would seem like a common injection question, didn't provoke more response. But, I'm grateful for your opinion.

    Yes Ron, trigger points right in to the scalene did give me six days of relief. It was awesome! Doc says since it was temporary we could try ESI but another doc told me botox gives longer relief for muscles. I feel ESI are more for nerve related pain and trigger shots or Botox are more muscular related pain. You said it, it's more disc related. I guess if the ESI doesn't work I can at least rule out disc related pain. I have a photo of my cervical spine showing impingement and narrowing of the disc, yet my pain seems like trigger points.

    It's taken me 13 years to figure out that just because you might have an ugly MRI reading doesn't necessarily mean that's where your pain is coming from!
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 12/05/2013 - 9:33 AM
    It can be so bad that your muscles are full of knots. If the ESI works you will know that the cause is related to nerves coming off the spinal column. It there is little relief, the source could be something else.. I get about 6 weeks relief from ESI and my PT got the same amount from botox.
  • My ESi is in two hours. I will update my status in a week or so. What tells me it might not be nerve related is cause I feel tender pain in my scalenes just on the right side of my neck---therefore it's localized pain. My doc seems to think ESI will help more than Botox. I hope he's right.
  • AnonymousUserAAnonymousUser Posts: 49,671
    edited 12/06/2013 - 11:37 AM
    I hope it wasn't so bad for you!! What level did they do it at? tonight will most likely be the most painful - use ice - then tomorrow, it will ache, moving around helps. You should start to feel real relief in 3-5 days if it is nerve related.
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