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Epidurals vs. Facet Joint Injections

I've had persistent lower back (and some leg) pain for 2 years now. Not intense, more low to mid level crampy pain. I had an epidural done at the L5S1 level last year. No impact at all. 

I went to another doctor today, and he suggested that I could do another epidural at L5S1 and L4L5. Alternative he suggested a facet joint injection for diagnostic purposes (followed by ablation, although he only referred to as 'burning nerves'). Also, for insurance reasons, I would prefer to get this done before the end of the year if I decide to do it all. 

So does it make sense to repeat the epidural injection (but including a different level) ? Alternatively, is it worth trying the facet joint injection at all ? No other doctor I've visited has suggested a facet joint injection. Is this a relatively infrequent procedure (so only a few pain management doctors might suggest it) ?

 [ I should add that the doctor I visited yesterday didn't do that much of a physical exam, he seemed to rely  on radiologists report which suggested I may have facet arthropathy). 



  • memerainboltmemerainbolt IndianaPosts: 5,587

    Reading your post was like reading everything I've been through. I've had the ESI's, trigger point and facet injections. All of these are done to find relief for the patient. One of the last resorts is to do an ablation on the nerves causing the pain. No one can guarantee they will work. But my doctor told me if the facet injections worked I would have about 6 mos. of relief.
    Below is a link for you to read on facet joint injections.

    https://www.spine-health.com/treatment/injections/cervical-thoracic-and- lumbar-facet-joint-injections

    Spine-Health Moderator
    Please read my  Medical History
  • Back in 1996 before I had my L-4 through S-1 screw fusion which includes L-5 I was having pain in my lower back and didn't have any reduction in pain with steroid injections however I did have 2 (left and right) Facet Rhizotomies done. (burning of the nerves) The right one lasted for about 4-5 months with about 85% reduction in pain on the right side before the nerves grew back and I was right where I started from. The left side was done and had no relief from the Rhizotomie. Just taking it from my experience, L-4 and L-5 have similar pain symptoms as far as pain radiating down the legs, groin, buttocks, etc,. First thing is I would try anything before I would get surgery. Two..if you are questioning your Dr. and he is not answering your questions to your satisfaction then I would get a 2nd professional opinion and this means from a neurologist, neurosurgeon or orthopedic surgeon which I did and unfortunately it lead to 5 more surgeries including 3 more fusions, removal of hardware on two and stenosis at L-3 which was my last one in 2004. I had an MRI last week and it looks as though I am in for my 4th fusion at L-2 through L-3. Once a back patient always a back patient! Good luck!

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