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Facet vs. Epidural Injection

AnonymousUserAAnonymousUser Posts: 49,321
edited 06/11/2012 - 8:19 AM in Spinal Injections
I've had 5 epidural injections but I'm going in for a facet joint injection next week. What is the difference between the two injections? Has anyone had a facet joint injection?


  • I get cervical facet joint injections every 3 months, from which I usually get 7 weeks or so relief. Still get a bit sore, but much less and easier to control.
    Injection is made beside the joint in between the facets, in the tissues there. The steroids work on the inflammation.
    I understand that an epidural is injecting into the spine itself.
    Others who have had it may be more precise.
    With mine, it took a few procedures to determine the best facet joints to inject into. I now have 7 each time, top to bottom of neck. That fixes it!
  • A steroid injection needs to be located at the source of the pain to be effective, and the pain needs to be caused by inflammation. Unfortunately, it's often not clear where exactly the pain source is and/or if it's due to inflammation. So, your doctor may try several injections to help figure it out. Steroid injections are sometimes used as a diagnostic tool to pinpoint the location of the pain source and whether or not it's due to inflammation.

    For an epidural, the steroid is injected into the epidural space. For a facet injection, the steroid is injected into the facet joint.

    I recently had my first steroid injections for my back problem; the first was epidural (ESI), and the second was facet.

    My first injection was an ESI on one side (L5/S1), and it gave very minor relief, mostly in my leg vs. back, that was gone within 2 weeks.

    My second injection was actually 3 injections: a caudal plus 2 facet (both sides). It provided substantial relief in my back, plus relief in my buttocks and legs, that started to fade after 2 weeks, but didn't completely go away for about 4 weeks.

    For me, the relief was too short-lived for this to be a viable pain management technique.

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  • My one and only epidural injection (for DDD and nerve impingement stuff) was a diaster; not only did it double the pain, but spread it down to places where it never hurt before. It never did go back to pre-shot levels.

    However, I had 6 facet joint injections a week ago and the first three days were heaven. Nothing hurt! I hardly knew what to do with myself! :)

    That euphoria wore off though, as the pain has crept back. It seems to be less than usual, so I'm counting it as a success. (I go back in a month for more.)
  • ESI and FJI.

    For me, the ESIs (all 3) have provided tremendous relief. The FJI did not- just added some extra cramping, but no relief. I just had my 3rd ESI on Friday- my T & C spine went into severe spasms during the procedure (at L5-S1 where my disc is herniated), so I'm REALLY sore from that- but i'm already having HUGE amounts of relief in my lower back. My upper back is really sensitive again due to the spasms- but I'm hoping that after a couple of more days the soreness will wear off and i'll have relief of my entire back for once! :)

    I would highly recommend ESIs- I know some people have horror stories, but they have really saved my life!
  • I want to thank everyone for replying. I'm incredibly nervous about the FJI as my last EPI was horrible and I'm afraid the doctor will hit a nerve again. At least they gave me a ton of Valium to ease my mind. The prospect of pain relief also helps tremendously in my decision to have the injection.

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  • I had a TESI done with light sedation. It did not hurt very much. No relief.

    I had four facet injections done (L4 / L5 and L5 / S1) at the same time. I elected to have no light sedation this time as I wanted to get in and out as quick as I could. Big mistake!

    The first two went OK, the second two hurt like :jawdrop: !!!

    I will say I have had some relief in the low back, but the side effects of the steroids suck (for me).

    The issues with my right leg have not changed. Maybe that is because I have a herniated disc pinching the nerve...

    Anyway, now on to the neck problems.... :(
  • All my injections were in the lumbar region. I had more discomfort after the ESI's than after the facet injection. I was not sedated for any of them. And the discomfort was fairly minimal, just some soreness at the spot of injections. I brought a small pillow for the car ride home, which helped immensely with the ESI's. And I laid on my side when I got home, to stay off my back, but still rest and take it easy.

    My ESI's didn't give me much pain relief at all. The facet joint injection did give me some. My doctor said that this was all diagnostic, and she said the next possible step was to do a nerve block at the facet joint nerves to see if I am a good candidate for nerve ablation.

    I decided to wait, since I was starting acupuncture. Well, I've had 8 acupuncture treatments, and although I am in less pain now than when I first started, I have hit a plateau.

    So now I have made the appointment for a nerve block and hope that I will be a candidate for the nerve ablation. Then I will hope that acupuncture can help with whatever pain remains after that.
  • My doc done both for me the SI and then followed it with a FJI. I have hurt most of the week but still have the pain down the left leg into my toes, but I kinda don't feel any different than before, but waiting to see if I do. Praying.. I had hand surgery and they let me borrow an tens unit and I didn't need it anymore for my had so I put it on my back and found I really like it! OH yeah buddy!!! :)

    My problem is I feel like someone is pushing an nail in my tail bone and they are pulling the nail back out then doing it again, again and again. :O

    If I had a choice to choose from I would choose the facet joint injection I had more pain meds working in the joint than the epidural injection. I wished the lidicane worked longer so I wouldn't feel the darn thing hurting all the time.

  • flyjack- I have had different types of injections in my cervical and lumbar areas. I know they had different names but I truly do not know what they are injecting or where. I see my PM dr this Thurs and her nurse called me to have lumbar epidural steroid injections. I have a new L3-L4 problem with a nerve impingement but I do not want the steroids. I have bad side effects. I'll see what she says in person. :( jade
  • I had facet injections last Wed. Personally I think they hurt worse than an epidural but I have alot of arthritis in the facet joints. I ended up have 6 injections. 3 on each side starting with L3/4-L5/1. I am starting to see a little bit of relief from them. Good luck I hope they work for you.
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