For chronic back or leg pain, there are a few procedures in pain management today that are extremely common. Facet injections and epidural steroid injections are the most popular outpatient procedures performed for obtaining pain relief today. What is the difference between these procedures?
From the neck all the way down to the sacrum, they are approximately the size of a thumbnail and contain cartilage just like other joints of the body such as the hip or the knee.
So if a person has chronic back or neck pain and physical exam and imaging studies confirm the arthritis, steroid injections into the symptomatic facet joints can help for months at a time. Of note, when an Arizona pain management doctor performs a facet injection, the needle does not go into the spinal canal. This is because the facet joints are located in the back of the spine outside of the area where the spinal cord and nerve roots reside.
The predominant indication for a facet joint injection is chronic neck or back pain due to facet joint arthritis. If an individual has a significant leg pain or arm pain component, this typically results from nerve roots being compressed. This is when epidural steroid injections come into play.
When a nerve root gets pinched, it is often the result of a disc herniation, which is commonly known in layman’s terms as a slipped disc. This can compress a nerve root and cause significant inflammation which then leads to either sciatica in the leg or what is called radiculopathy in the arm.
In the case of spinal stenosis, arthritis forms in the spine which overgrows bone and soft tissue. This can compress one or multiple nerve roots leading to leg or arm pain as a result.
In these instances, a facet injection is not going to help symptoms from the pinched nerve. It would be an epidural steroid injection that should be performed. This involves a Phoenix pain management doctor placing the needle into the spinal canal and placing steroid medication around the area of the pinched nerve.
There are a few different varieties of epidural steroid injections, and all of them involve placement of steroid into the spinal canal. Interlaminar injections are the simplest and involve medication being placed right over the spinal cord area.
A transforaminal epidural injection involves placing the needle at the point where the nerve root leaves the spinal canal, and this achieves placement closer to the area of nerve root compression. A caudal epidural steroid injection involves medication placement at the lowest area of lumbar spine, which is excellent for reaching multiple areas of nerve root compression.
So one big difference involves where the medication is placed. Facet injections go right into the small joints in the back of the spine, and epidural injections involve medication placed right around the spinal cord and nerve roots.
The other big difference is the indications for these procedures. Facet injections are from chronic neck or back pain, whereas epidural steroid injections are indicated for sciatica and radiculopathy due to nerve roots being pinched.
Both of these injections have been performed for decades in pain management Phoenix because they work very well. Epidural steroid injections have been shown to provide good to excellent pain relief in over 75% of those receiving them.
If you live in the Phoenix and Scottsdale metropolitan area and are looking for the premier pain clinics in Arizona, let Arizona Pain Specialists help you. The pain management doctors and chiropractors are Board Certified and Fellowship trained with the most comprehensive options available.
Call today at (602) 507-6550!