Steroid facet joint and SI joint injections

My pain clinic will only give repeat injections after a year ! This is just ridiculous as everyone seems to acknowledge that effects only last 6 months Max.

If any one on this forum has had repeat injections would they let me know what the intervals are and which Health Board they live in.

If I get an indication that my Health Board ( Scottish Highland) is falling short from the norm then I might be encouraged to to research this issue properly and get statistics from each Board to take to mine .

Thank you

26 Replies

  • Hello Dee

    Did they give any reason?

    Dr Sabu James Pain Consultant NHS Lanarkshire every 6 monthd give or take.

    He won't do them any more often because risk of infection. That has been pretty standard for both here, NHS Tayside and Yorkshire. So cost doesn't appear to be the issue.

    Sounds like admin up to their old tricks of telling pain clinics what they can't have. They should be sacked

    Any help?


    Pat x

  • Morning Pat. I think it's an issue of theatre space and staff. I am thinking if I can gather enough information from other Health Boards then I have a case to take to mine.

    Injections are relatively successful for me but the benefits are only about 4-5 months. I am looking therefore at 6 months of pain and increasing amounts of morphine to get me through the rest of the year. Or try to scrape together enough money to have them done privately. I'm fortunate that at the moment I can do this but really I shouldn't have to.

    How are you doing by the way ?

    I'll message you as I've had another bumpy ride two weeks which is like to share . (its the polite way of saying dump on you) .

  • Sorry to hear about your dog it's like losing a near friend lost so many little dogs over the years all special got a photo album of them all

    I know how you feel

  • So sorry to hear about your dog,it's like losing a member of your family (sometimes worse☺) maybe when time passes and thing are easier you could maybe get a pup or a wee rescue dogs,I find my 2 dogs the best tonic in the world for making me happy and taken my mind off pain,take care of yourself x

  • On the dog Pat. So sorry especially since it was young. I miss having a dog a lot. Is your other collie pining ?

  • Hi, In West Wales you would be very fortunate to receive treatment once a year! I have had FJI's on 8 ocassions over the past 12 years, such is the waiting list here.

    I know that in Belgium for example they will only do the procedure twice in total, if the patient is not 'cured' (even though fgi's are not a cure) of pain they will look at other factors. I think you are very fortunate receiving these every 6 months and would hail the efficency of your local HB. My previous research shows the procedure costing, taking account of Anaesthetist/colleague and other theatre staff to be around £2k a time, more in my case as xray equipment required (so not cheap compared to normal meds).Take care.

  • What are 'normal' meds? If they don't relieve any pain and imjections do 0 then it makes sense to do injections.

    We have a wonderful pain team here and David has a lifetime mebership.


  • Hi, 'Normal meds' in most people's case is opiates/anti-inflammatory etc. You will know the aim of all pain management teams is to relieve pain whilst getting the patient to reduce their reliance on such meds if possible. On a few ocassions when some relief has been found with FJI's I know I have been able to reduce my oral intake. As the NHS here in Wales is 'devolved' it is not perhaps as efficent (frequent reports confirm this to be the case). Pain management budget has been drastically reduced despite the ever longer waiting list which results in the time between routine procedures being lengthened. Of course it makes sense to have injections if they are beneficial but other factors are impacting on the overall provision. Take care.

  • There is no anaesthtist when I get them down. The doctor and two nurses in theatre. 2 grand seems a lot

  • Dr James our consultant is also an anaesthetist. They are the pain expeerts knowing what causes pain and how to reduce it.

    Ask him next time Dee.


  • I think you'll find your doctor is a consultant anaesthetist as they normally run pain mangement provision.

  • Hi Talgarh . I've checked out the private rates for steroid injections and its about £550 to £650 depending on how many needs done. That's way less than £2000. That's with 2 nurses and the surgeon.

  • Not ridiculous. There is increasing evidence that spinal steroid injections can contribute to bone necrosis and other side effects, so its not advisable to do them too often. Some places will do them more often if they are just putting the steroid near the joint rather than right into the facet joint or SI joint, but you don't get so much benefit from those. You could ask about other forms of injection that aren't steroid, or about nerve ablation instead.

  • Could you check privately to see what the recommended interval for you might be and then hit them with that? It's absurd that they are leaving people in pain with arbitrary intervals ? Or is there some new research saying that due to side effects these injections are safest in x intervals? I think I had 3 in 2 years in Oswestry but the pain consultant there was having to work Saturdays to keep up with demand! Best wishes..

  • We are almost adjoining HB and have no problems. David gets his roughly 5-6 months depending on work load. Our consultant only does these procedures once a week so can only fit in a certain number. But in 6 yrs never had to wait 12 months. Consultant would have a riot on his hands.

    I have a sneaky suspicion Highland are rationing due to cuts.


  • My injections last about 6-8 weeks I'm told they should last about 3 months. we are lucky if we get 2 a year this is due to only having one consultant working on his own we used to have 3 one retired one had a accident so it boils down to money

  • Earthwitch is right. Repeated steroid will weaken bone. Whether that is the reason for the rationing is another matter.

  • I am scheduled for my first "xray guided epidural injection of the cervical spine" on Monday. My husband had 2 of these done last year into his lower back, but they were 2 months apart. I am scheduled for a second injection 2 weeks after the first. The cost for my husband's injections were $6,000.00 US Dollars. That amount was for each injection. I have insurance now that will pay for most of the cost. I think my co-pay will be in the $300 US Dollar range. The injections were not helpful for my husband so we did not continue them. I think my injection into the neck has a better chance for relief. I hope.

  • Repeat injections have a lot of risk of more damage to joints as oeasteoarthritis (research shows). There are much better orocedures available without these nasty effects - facet joint denervation. It heats the nerves up and destroys parts of it, that stops the pain signals and usually lasts 1year - procedure is almost the same than the steroids, maybe 15min longer. But the NHS is on cutback mode, i had mine done privately - £3500 - worth every single penny!!!!

  • I've had that procedure once but I require sedation as I can't tolerate the pain. I threw up the first time. So it more expensive and requires more staff.

    Its given here after 2 rounds of successful steroid treatment.

  • Oh yes, sedation is needed - the NHS save on that too and won't offer - private is no problem (well, no full sedation of course as they need to know which nerves they pick). That must be awful throwing up but completely understand - its not nice at all.

  • I have had 3 rounds of SI injections about every couple of months. Each time I request a repeat they were given to me. I live in the South.

  • South Scotland?


  • No I live in England.

  • I wish i could get one my pain clinc will not give me one or my doctor even though my specialist and osteopath have suggested it hope you manage to get sorted pain is no fun xx

  • Hi Dee, I have been having these injections for five years now , i have four at a time and started off with having them every six months they work very well for me as they don't work for everyone. But as time went on like all meds your body gets used to it ,the surgeon explained to me that eventually they would stop working so now i get the injections every nine to twelve months . There is no set time on how long the injections last as that depends on the effect they have on each individual plus the N.H.S. will only fund the use of them to be used at six month intervals, I live in Worcestershire. I hope the information i have given you is helpful. Triciaj.x

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