Injection Therapies Explained: What You Need to Know About Epidural, Facet Joint, and SI Joint Injections

When pain interferes with daily life, even simple activities can become challenging. For many patients, targeted injection therapies offer meaningful relief without surgery. Epidural steroid injections, facet joint injections, and sacroiliac (SI) joint injections each play a unique role in treating and diagnosing spine-related pain. Understanding how they work can help you make informed decisions about your care.

Why Injection Therapies Are Used

Injection therapies deliver medication directly to the source of pain. This targeted approach can:

• Reduce inflammation
• Provide temporary or long-term pain relief
• Improve mobility
• Help diagnose the true pain generator

While these injections are not always a permanent fix, they are an important part of a comprehensive treatment plan that may also include physical therapy, activity modification, and lifestyle changes.

Epidural Steroid Injections (ESIs)

What They Are

Epidural steroid injections deliver anti-inflammatory medication into the epidural space around the spinal nerves. They are commonly used for conditions where nerve irritation is the main issue.

Best For

• Herniated discs
• Sciatica or radicular leg pain
• Spinal stenosis
• Nerve compression
• Nerve root inflammation

What to Expect

The procedure is performed under X-ray guidance to ensure accurate placement. Relief may be felt quickly or develop over several days. ESIs often provide weeks to months of relief and can help patients return to normal activities with less pain.

Facet Joint Injections

What They Are

Facet joints help support movement in the spine. When these joints become arthritic or irritated, they can cause chronic neck or back pain. Facet joint injections place medication directly into or around these joints.

Best For

• Chronic neck or back pain
• Spine arthritis
• Pain worsened by twisting or extension
• Facet joint syndrome

What to Expect

Facet injections are often both diagnostic and therapeutic. If the injection provides short-term relief, your provider may discuss longer-lasting options such as radiofrequency ablation.

Sacroiliac (SI) Joint Injections

What They Are

The SI joints connect the spine to the pelvis and are a common source of low back or buttock pain. SI joint injections help diagnose and treat inflammation within this joint.

Best For

• Low back pain radiating to the buttock or thigh
• Pain with standing, climbing stairs, or prolonged sitting
• SI joint dysfunction

What to Expect

Using imaging guidance, medication is placed directly into the SI joint. Many patients experience relief within a few days. SI injections also help confirm whether the joint is the true source of pain.

When to Consider These Injections

Your provider may recommend injection therapy if:

• Pain interferes with mobility, sleep, or daily function
• Conservative care has not provided enough relief
• Imaging studies suggest inflammation or joint dysfunction
• Diagnostic clarity is needed to guide next steps

These injections are minimally invasive, performed on an outpatient basis, and require little downtime.

Are Injections a Long-Term Solution?

Relief varies from patient to patient. Some experience lasting improvement, while others may benefit from repeat injections or additional therapies. Your provider will help customize a treatment plan based on your needs and goals.

Final Thoughts

Epidural, facet joint, and SI joint injections are valuable tools in modern pain management. They can reduce pain, improve function, and provide important diagnostic information. If you are experiencing persistent spine-related pain, these targeted therapies may help you regain comfort and return to the activities you enjoy.