Back Pain Injections: Epidural & Facet Joint Treatment

If you live with chronic back pain, it can often seem like a full-time job. It controls not only how you move and sleep, it also influences your thoughts. For many living in Valley Stream and Queens, the idea of surgery is intimidating; however, not being able to tolerate daily pain is even worse. You may be mired there in that sometimes-frustrating middle ground: Medication isn’t doing the trick, but it’s too soon (or you’re not eligible) for something like a big operation.

At Comprehensive Orthopedic & Spine Care, we fill that gap with state-of-the-art interventional pain management. Dr. Joseph E. Weinstein, DO, and Dr. Carlos Castro, MD, are experts at finding the underlying cause of pain without using surgical procedures. We treat—not just mask—your symptoms, focusing on back pain injections under imaging guidance to help reduce inflammation, soothe irritated nerves, and improve your life – often in one visit.

Understanding Back Pain Injections

When medicines you can swallow and physical therapy don’t help enough, pain shots in your lower back or into the neck could be a game-changer. These are not painkillers in the classical sense. They’re specific therapies, delivering powerful anti-inflammatory medicine right to the injured site on your spine.

How They Work

Unlike a pill, which has to get processed throughout your system, with an injection, you’re going right toward the site of the problem. This allows for:

• Medicine concentration at the site of the injury — ain’t no bandage make itself do that!
• Decreased possibility of systemic side effects
• Faster relief—often within days
• Diagnostic information (which helps us confirm exactly which nerve or joint is causing your pain)

Our Injection Treatments

We provide comprehensive services for injection medicine and treatments for back pain, designed to meet your individual needs.

Epidural Steroid Injections (ESI)

If you have sciatica, herniated discs, or spinal stenosis, it is frequently the result of inflamed spinal nerves. An epidural steroid injection delivers a very strong anti-inflammatory corticosteroid directly into the epidural space, which is the area lying right outside your spinal cord and nerve roots.

Best for:

• Radiating leg pain (sciatica)
• Herniated or bulging discs
• Spinal stenosis
• Degenerative disc disease

The Procedure:

Dr. Weinstein or Dr. Castro uses fluoroscopic (X-ray) guidance to accurately place a fine needle near the inflamed nerve root. The process is just minutes, but the relief can be months long, which createsthe  space your body needs to heal naturally or progress in physical therapy.

Facet Joint Injections

The facet joints, located down the back of your vertebrae, are small connections that enable your spine to bend and twist. Just like knees or hips, they can get arthritis. When it does, it triggers intense, aching low back pain that can make bending down or standing up torturous.

A facet joint injection consists of an anesthetic and steroid medication injected into the capsule of the joint.

Best for:

• Spondylosis (a form of arthritis in the spine)
• Chronic low back pain without radiating to the legs
• – You experience pain that gets worse when your back is twisted or bent.
• Whiplash injuries

Medial Branch Block & Radiofrequency Ablation (Full Video Transcript) Okay, medial branch blocks and radiofrequency ablation.

Sometimes we even need to interrupt the pain signal itself. This is a medial branch block, which freezes the nerves that feed the facet joints. If it brings relief, then that, without a doubt, is the diagnosis.” We can then go on to doing Radiofrequency Ablation (RFA) a more permanent treatment in which we use heat energy to “kill” the pain-transmitting nerve fibers for 6-12 months (+).

Sacroiliac (SI) Joint Injections

Your SI joint is where your spine joins your pelvis. Dysfunction here is a surprisingly frequent -- though frequently missed -- source of lower back and hip pain. We are able to silence this inflammation in the joint with these precise injections, resulting in tremendous relief for anyone suffering from gross SI joint instability.

Why You Should Choose Comprehensive Orthopedic & Spine Care

You have options for orthopedic treatment in New York. Here is why patients entrust us with their backbone health.

1. Precision & Safety

We don't guess. All injections are image-guided. This real-time X-ray imaging makes sure that the medicine is delivered precisely where it’s needed — maximizing relief and reducing risk.

2. Dual Expertise

You’re getting the expertise of two people here: Dr. Joseph Weinstein, a board-certified orthopedic surgeon who trained at the Hospital for Special Surgery (HSS), and Dr. Carlos Castro, a globally recognized spine surgeon with an international fellowship training. And they know about the spinal column physically and functionally.

3. A Conservative-First Philosophy

We are surgeons, but we don’t need to operate. Our aim is to get our patients well without the operating room whenever we can. Injections for back pain are part and parcel of this philosophy, enabling many to bypass surgery entirely.

4. Convenient Locations

Pain makes travel difficult. That's why we offer high-tech, full-service offices in:

• Valley Stream, NY (Long Island)
• Rego Park, NY (Queens)

What You Will Experience During Your Visit

We realize that the notion of a “shot in the spine” can be anxiety-producing. Every step is about your comfort.

• Consultation: We analyze your MRI/CT scans and explain your symptoms in easy language.
• Preparation: The local anesthetic is used to numb the injection site. You'll be awake but comfortable.
• The Injection: The Doctor finds the right spot, using X-ray guidance to place the needle. You may feel a little pressure for a moment. “There’s a 15-minute wait after the actual injection.”
• Recovery: You will spend a brief period of time resting in our office, and then you can go home. Recovery: Most patients are doing light activity the day after.

Frequently Asked Questions

Is the injection painful?

“For most, it is pressure, not sharp pain. We inject a local anesthetic to numb the skin and tissue before the treatment.

How long does it last?

It varies by patient. For some, it's a few weeks of relief, while others enjoy pain-free months or even years. The objective is to stop the cycle of pain so that you can engage in rehabilitation.

Can I drive home after?

As a general rule of thumb, we suggest that you be driven afterward, particularly if you’ve had an intervention in which your legs could be numb for a short period or if you’ve been sedated.

How many treatments can I get?

We usually do not give steroid injections more than 3-4 times/year because of the potential for side effects of this medicine.