Cervical Epidural Steroid Injection

The duramater is a protective covering of the spinal cord and its nerves. The space surrounding the duramater is called the epidural space. In the neck, it is called the cervical epidural space.

The cervical area of the spine has seven bones, called vertebrae. Soft discs found between them cushion them, hold them together, and control motion. If a disc tears, chemicals inside may leak out. This can inflame the duramater or nerve roots and cause pain. A large disc tear may cause a disc to bulge, inflaming the duramater and nerve roots, and cause pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.

What is a Cervical Epidural Steroid Injection Procedure?
This is an injection into a space (epidural space) of the spine next to the cervical spinal cord and exiting nerve(s) that are the likely cause of your head, neck, shoulder, and/or arm pain.

Why is a Cervical Epidural Steroid Injection Procedure helpful?
It is helpful in the diagnosis and treatment of your head, neck, shoulder and/or arm pain, which is likely due to a disorder of your cervical spinal cord and exiting nerve(s). One medication is used for the injection: a long-acting anti-inflammatory steroid agent. At first, you may or may not experience temporary pain relief after the injection. Then, after 48 to 72 hours, you will likely experience pain relief after the injection due to the effects of the long anti-inflammatory steroid agent.

What happens during a Cervical Epidural Steroid Injection Procedure?
You may be given Diazepam orally or IV sedation for the procedure. You will sign the consent prior to getting any Diazepam. Then you will be asked to lie on your stomach on the procedure table. The skin of your lower neck at the injection site will be cleaned with an anti-bacterial solution. You will experience an initial sting at the injection site, as the skin will be numbed with a local anesthetic numbing agent. Then, the doctor will guide the procedure needle by way of real-time x-ray to the target structure of your spine. Once the needle is in the epidural space, a small amount of dye may be injected to confirm that the needle is in the right place. Then injection of the long-acting anti-inflammatory steroid agent is injected in the epidural space. The injection procedure itself will be brief, usually lasting less than 10 minutes.

What happens after a Cervical Epidural Steroid Injection Procedure?
You will be observed for at least 10-15 minutes in the recovery room for your response to the injection. Your oxygen level, blood pressure, pulse rate, and respiratory rate will be monitored in the recovery room. You may become a little sore at the soft tissues of the procedure site, which is normal and to be expected. You may apply an ice-pack to the sore area of the procedure site. The soreness at the procedure site should go away in a couple of days. It usually takes 48 to 72 hours to experience relief of your head, neck, shoulder, and/or arm pain from the long-acting anti-inflammatory steroid agent. A follow-up appointment will be made for you.

Can I go to work the next day after a Cervical Epidural Steroid Injection Procedure?
You can return to work the next day.

How long can I expect pain relief?
Depending on the amount of inflammation, an injection could offer pain relief for a few weeks to a few months. For some, a single injection could result in long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms will be helped by a single injection. The epidural injection may need to be repeated 3-4 times after a few weeks or months depending on individual’s pain.