A cervical steroid injection (sometimes called a cervical epidural steroid injection) is a common pain management treatment. It helps reduce the inflammation and pain associated with nerve root compression in the neck, shoulders, and arms caused by a pinched nerve or inflamed nerves in the cervical spine.
When a nerve is compressed, it becomes inflamed, which can lead to pain, numbness, tingling, or weakness along the nerve. Nerve roots that become compressed in the cervical spine are often the result of a herniated disc, spinal stenosis, or arthritis.
A cervical steroid epidural injection is performed in the neck area of the spine.
An epidural injection goes into the epidural space, directly over the compressed nerve root. The space surrounding the spinal cord and nerve roots is the epidural space (epidural means “around the spinal cord”). The epidural space is a fat-filled “sleeve” that surrounds the spine and provides cushioning for the nerves and spinal cord.
The injection consists of a steroid medicine (also called a corticosteroid) and usually an anesthetic medicine. Together, these medicines spread throughout the cervical epidural space to provide relief to compressed nerve roots in the neck, which can reduce pain and swelling in and around the spinal nerve roots. The injection may provide pain relief permanently or for several months, allowing the damaged nerves to heal.
Although the injections do not change the underlying condition, they can break the cycle of pain and inflammation and allow the body to compensate for the condition. In this way, the injections can provide benefits that outlast the effects of the steroid itself.
The procedure is often done on an outpatient basis with the aid of imaging guidance, such as fluoroscopy (multiple x-ray images) or computed tomography (CT or “CAT” scan). The imaging helps the doctor place the needle in the exact location to target the area causing the pain; wherefore, the patient can receive maximum benefit from the injection.
Most patients return to their previous level of activities the day after the procedure. Some patients request mild sedation for the procedure, but many patients undergo the injection using only local anesthetic.
The treatment is not recommended for back pain that begins suddenly.
Conditions Treated with Cervical Steroid Injections
A cervical steroid injection is one of many methods doctors use to relieve pain, along with physical therapy, oral medications, and surgery if the pain does not respond to conservative treatments.
An epidural injection may be performed to help alleviate pain caused by:
Post-operative failed back surgery syndrome (FBSS) – chronic back or leg pain after spinal surgery.
Other injuries to spinal nerves, vertebrae, and surrounding tissues.
How Do Cervical Steroid Injections Work?
The different types of medications injected into the epidural space create different effects for patients. Corticosteroids act as an anti-inflammatory agent, reducing swelling and nerve irritation while allowing the nerve time to heal and prevent further discomfort. The delivery of the medication by injection directly into the epidural space allows it to move throughout the epidural space, coating the inflamed or irritated nerve roots.
The duration of improvement from a steroid injection varies. Some patients have permanent relief; however, the effects may not last long in other patients. In some cases, a series of injections may be necessary before the patient experiences significant pain relief. In cases where the pain returns, another series of injections or an alternative treatment may be necessary.
Types of Epidural Steroid Injections
Epidural steroid injections can be administered anywhere along the spine. The location depends on where the patient experiences pain. The name of each procedure describes the site of the injection. Steroid injections in the neck are called cervical epidural injections and treat pain in the neck, shoulders, and arms.
Injections in the middle of the back are called thoracic epidural injections and treat pain in the back and arms. Low back injections are called lumbar epidural injections and treat sciatica and low back pain.
Who Can Benefit from a Cervical Steroid Injection?
Cervical steroid injections can help reduce pain and improve function so the patient can return to normal daily activities. The primary objective of the procedure is to decrease the inflammation associated with a variety of spinal conditions, such as herniated disc, cervical spinal stenosis, and degenerative disc disease with nerve root impingement.
Every individual is different. Most people who receive a cervical steroid injection obtain some improvement. Others may find the effect is temporary and offers little to no long-term relief. In some cases, a series of injections may be necessary to receive maximum benefit from the medication. If the epidural injections do not help alleviate your pain, your doctor will most likely recommend a different therapeutic approach.
Patients who also engage in exercise programs, activity modification, and ergonomic corrections have more positive results than with the injections alone.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including cervical steroid injections. By using a comprehensive approach and cutting edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.