A facet joint injection targets a specific small joint in the spine called a facet joint. An epidural steroid injection is delivered into the epidural space the area between the spinal cord and the outer protective covering of the spine. Both treat spinal pain, but they work at different anatomical locations and are used for different types of pain. Choosing the right injection depends on the underlying cause of your symptoms, which requires a clinical assessment by a specialist.
Facet Joint Injection vs Epidural — Quick Comparison
| Facet Joint Injection | Epidural Steroid Injection | |
|---|---|---|
| Target location | The facet joint, a small joint at the back of the spine connecting adjacent vertebrae | The epidural space, between the spinal cord covering and the vertebral canal |
| Mechanism | Reduces inflammation within the joint itself | Delivers anti inflammatory steroid medication to the nerve roots and surrounding tissue |
| Best for | Pain caused by facet joint arthritis, degeneration, or inflammation, often felt as localised back or neck stiffness | Pain caused by nerve compression such as a herniated disc, spinal stenosis, or cervical radiculopathy causing arm or leg pain |
| Pain pattern it treats | Local spinal pain often worse with twisting or extension movements. Usually does not radiate into the arm or leg. | Radiating pain often shooting down the arm or leg. |
| Procedure type | Injection directly into the joint under image guidance, usually fluoroscopy or ultrasound | Injection into the epidural space under image guidance |
| Number of injections | Often a series of two to three, or combined with a medial branch nerve block | One to three injections, typically two to four weeks apart |
| Duration of relief | Weeks to months, varies between patients | Weeks to months, varies depending on the underlying cause |
| Diagnostic use? | Yes. A positive response helps confirm the facet joint as the pain source | Less commonly used diagnostically. Primarily therapeutic |
What Is a Facet Joint Injection?
A facet joint injection delivers a small amount of local anaesthetic and corticosteroid directly into the facet joint. Facet joints are the paired, small joints that connect each vertebra in the spine — there are two per level, running from the base of the skull to the sacrum. When these joints become inflamed through degeneration or injury, they produce localised back or neck pain that worsens with specific movements such as twisting, bending backwards, or standing for extended periods.
There are several types of facet injections depending on the spinal region. Lumbar facet joint injections target the lower back. Cervical facets injections target the neck and upper spine. Thoracic facet injections address the mid back. A medial branch nerve block is a closely related procedure that targets the nerve supplying the facet joint rather than the joint itself, and is often used diagnostically to confirm whether the facet joint is the source of pain before a radiofrequency ablation procedure.
At Renew Skin and Health Clinic, facet joint injections are performed by Mr. Amit under image guidance. For more information, see our facet joint injections treatment.
What Is an Epidural Steroid Injection?
An epidural steroid injection delivers corticosteroid medication into the epidural space — the area between the outer covering of the spinal cord (the dura) and the inner walls of the spinal canal. The medication reduces inflammation around compressed nerve roots, relieving the pain, numbness, or weakness that these nerves produce.
Epidurals are most effective when pain is caused by nerve compression rather than joint degeneration. Common causes include a herniated or prolapsed disc pressing on a nerve root, cervical radiculopathy (nerve compression in the neck causing arm pain), lumbar radiculopathy (causing sciatica), and spinal canal narrowing (stenosis). Different delivery routes are used depending on the level of the spine and the specific nerve root involved — including interlaminar, transforaminal (which targets a specific nerve root directly), and caudal approaches.
For more information about private epidural injections at Renew Clinic, visit our epidural steroid injection treatment.
How Do You Know Which Injection Is Right for You?
The type of pain you experience is the most important distinguishing factor:
Choosing Between Facet Joint Injection and Epidural Steroid Injection
Facet joint injection is more likely if:
- Your pain is localised to the spine in the neck, mid back, or lower back
- The pain worsens when you twist, extend, or stand for long periods
- You have been told you have facet joint arthritis or degeneration on imaging
- The pain does not significantly radiate into the arm or leg
- You have not responded to physiotherapy or anti inflammatory medication
Epidural steroid injection is more likely if:
- Your pain radiates down the arm from the neck or down the leg from the lower back
- You have numbness, tingling, or weakness in the arm or leg alongside the pain
- Imaging has shown a herniated disc, nerve compression, or spinal stenosis
- You have been told you have cervical radiculopathy, sciatica, or lumbar radiculopathy
It is important to note that these two procedures are not mutually exclusive. Some patients benefit from both. In complex spinal pain presentations, a combination approach is sometimes the most effective strategy.
The only reliable way to determine which injection is right for your specific symptoms is a clinical consultation with a specialist who can review your history, examine you, and interpret your imaging.
Can a Facet Joint Injection and an Epidural Be Done Together?
Yes, in some cases. Spinal pain often has more than one contributing source a patient may have both facet joint inflammation and a herniated disc compressing a nerve root. In these presentations, a combined approach addressing both the joint and the epidural space may be recommended. This is discussed and planned at your consultation with Mr. Amit, where your imaging, symptoms, and clinical history are all taken into account before any injection is arranged.
Are These Injections Available Privately in Leamington Spa?
Both facet joint injections and epidural steroid injections are available privately at Renew Skin and Health Clinic in Leamington Spa. NHS waiting times for pain management interventions in the West Midlands can be lengthy private access allows patients to proceed directly to assessment and treatment without delay.
All spinal injection procedures at Renew Clinic are performed by Mr. Amit under image guidance. Consultations are available at Renew Skin and Health Clinic, 18 Guy Street, Leamington Spa, CV32 4RT accessible from Coventry, Birmingham, Warwick, and Rugby.
About the Author — Mr. Amit Amit | Consultant Neurosurgeon | GMC 6047850
Mr. Amit Amit is a Consultant Neurosurgeon and Spinal Surgeon based in the West Midlands with over a decade of specialist practice. His training includes the Royal Free Hospital London, Frenchay Hospital Bristol, the Royal Victoria Hospital Belfast, and a two year clinical fellowship in spinal surgery in Ohio, USA.
He currently practises at Woodlands Hospital, BMI Three Shires Hospital, The Meriden Hospital, and Nuffield Health Warwickshire Hospital, as well as at Renew Skin and Health Clinic in Leamington Spa.
He is a member of the British Association of Spine Surgeons (BASS), Eurospine, and the Society of British Neurological Surgeons.
Request a call back
Book a Consultation to Discuss Your Pain Injection Options
Not sure whether a facet joint injection or an epidural steroid injection is right for you? Mr. Amit Amit will carry out a thorough assessment of your symptoms, history, and imaging before recommending the most appropriate approach.
- Call: +44 1926 422 454
- Email:info@renewskinandhealthclinic.co.uk
- Address: Renew Skin & Health Clinic
18 Guy Street, Leamington Spa, CV32 4RT. United Kingdom. - Whatsapp: +44 1926 422 454
- Opening Hours: Monday to Friday, 10:00 AM – 6:00 PM (Telephone lines open daily 9:00 AM – 10:00 PM, including weekends)
Frequently Asked Questions
1. What is the difference between a facet joint injection and an epidural steroid injection?
A facet joint injection targets a specific spinal joint to reduce localised inflammation. An epidural steroid injection targets the epidural space to reduce inflammation around compressed nerve roots. Facet injections treat joint related spinal pain; epidurals treat nerve related pain radiating into the arm or leg.
2. Which is better for back pain a facet injection or an epidural?
Neither is universally better the choice depends on the cause of your pain. Facet injections work best for localised spinal pain caused by joint degeneration. Epidural steroid injections work best for radiating pain caused by nerve compression. A specialist assessment determines which approach is appropriate.
3. Can a facet joint injection and an epidural be done at the same time?
In some cases, yes. Patients with both facet joint degeneration and nerve compression may benefit from both procedures. Mr. Amit assesses each patient individually and recommends the combination most appropriate for their specific presentation.
4. How long does a facet joint injection last?
Relief from a facet joint injection typically lasts from a few weeks to several months, depending on the individual and the degree of underlying joint degeneration. Some patients benefit from a series of injections combined with physiotherapy to maximise the duration of relief.
5. How long does an epidural steroid injection last?
An epidural steroid injection typically provides relief for several weeks to several months. The duration depends on the underlying cause patients with a herniated disc that resolves over time may experience lasting relief, while those with structural stenosis may require repeat injections.
6. Are facet joint injections painful?
Most patients tolerate facet injections well. The procedure is performed under local anaesthetic, which minimises discomfort. Some patients experience brief soreness at the injection site for one to two days after the procedure.
7. What conditions are treated with epidural steroid injections?
Epidural steroid injections are used to treat conditions including cervical radiculopathy, lumbar radiculopathy (sciatica), herniated discs, degenerative disc disease, spinal stenosis, and nerve root compression. They are particularly effective when the primary symptom is pain, numbness, or weakness radiating down the arm or leg.
8. What is a medial branch nerve block and how does it relate to facet injections?
A medial branch nerve block targets the nerves that supply the facet joints rather than the joint itself. It is closely related to facet joint injections and is often used diagnostically — a positive response (significant pain relief) confirms that the facet joint is the source of pain and helps justify a more permanent treatment such as radiofrequency ablation.
9. Can I get a facet joint injection or epidural on the NHS?
Both facet joint injections and epidural steroid injections are available on the NHS for suitable patients, but waiting times for pain management procedures in the West Midlands can be significant. Private access at Renew Skin and Health Clinic in Leamington Spa allows patients to proceed directly to assessment and treatment.
10. How do I know which injection I need for my back pain?
The type of injection most appropriate for your pain depends on the cause of your symptoms specifically whether the pain originates from the facet joints or from nerve compression. A clinical consultation with a specialist such as Mr. Amit, which includes a review of your symptoms and imaging, is the only reliable way to determine the right approach.
CQC Registered Clinic
We are a CQC (Care Quality Commission) Registered Clinic.
What Our Client's Say
750+ Google reviews with 4.9 rating
