What is a Cervical Epidural Steroid Injection?
Cervical epidural steroid injections explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Reports show that an estimated 50% to 80% of adults will suffer from some form of neck or back pain over the course of their lifetime. There are many health conditions that can trigger neck and back pain, such as a pinched nerve, strained muscles, a herniated disc, and cervical radiculitis. Cervical radiculitis is a condition caused by an increased amount of pressure on the nerves in the neck, resulting in the nerves becoming inflamed and irritated as they exit the spinal canal. The irritated nerves radiating out from the spinal canal are what cause the body to feel pain. Patients with cervical radiculitis commonly report symptoms of shooting pain down one arm, along with a feeling of numbness and weakness.
In cases of chronic neck pain and cervical radiculitis, one of the most popular types of treatment is cervical epidural steroid injections. Studies have shown that this treatment option is very effective for reducing, and in some cases eliminating, cervical nerve pain. The exact mechanisms of action are still being researched, but it is primarily found that steroid injections serve to reduce nerve pain through their anti-inflammatory properties. Steroids have other benefits beyond the anti-inflammatory characteristics that also play a role in their effectiveness, such as the ability of steroids to stabilize nerve membranes and obstruct the conductance of ions, both of which are viable explanations for the relief of pain symptoms.
Recently a meta-analysis was conducted to test the effectiveness of cervical epidural steroid injections over the course of a ten year span. Results from the study endorse previous work supporting the use of steroid injections for managing pain.
Most patients who are treated with a cervical epidural steroid injection immediately feel some pain relief from the steroids. Most patients are able to resume normal daily activities shortly after the procedure. The long-term effects of steroid injections are still being researched. Many patients experience long-term pain relief from the injection, while others only have symptoms subside for a short period of time.
Since cervical epidural steroid injections are safe, patients who experience only short-term pain relief are able to receive multiple treatments throughout the course of a year.
How is a Cervical Epidural Steroid Injection Performed?
Within the body’s spinal canal, the spinal cord is enclosed by cerebrospinal fluid (CSF) that acts as a protective cushion for the nerve bundle of the spinal cord. The spinal cord and CSF are held in place within the spinal canal by a strong membrane. When a cervical epidural steroid injection is administered, it is injected into the epidural space, which is the area directly outside of this membrane. Before the injection, a topical anaesthetic is applied on the surface of the patient’s skin. The physician will commonly use an X-ray guide to confirm the proper needle placement through the epidural space and into the vertebrae. A contrast dye is also often used to test for proper needle placement prior to the injection, as well as to ensure appropriate distribution of the solution within the problematic area. Cervical epidural steroid injections are only administered in the areas with the most inflammation, reducing the amount of exposure the patient has to the injected steroids.
Cervical epidural steroid injections are performed within an outpatient setting since they are a non-surgical type of treatment. Most patients experience an immediate reduction of pain symptoms after being treated with a steroid injection. For patients who experience only short-term relief from cervical epidural steroid injections, it is recommended they undergo multiple injections over the course of the year to reduce or eliminate pain symptoms for a longer period of time.
Conditions Related To Cervical Epidural Steroid Injection
Cervical epidural steroid injections are frequently used by anaesthesiologists for the treatment of nerve pain near the head and neck resulting from compression of the nerve fibers.
Other health conditions that are also treated with cervical epidural steroid injections are:
- Cervical spondylosis
- Herniated disc
- Cervical radiculopathy
- Nerve compression (specifically, in the neck)
- Cervical spinal stenosis
For patients suffering from health conditions such as chronic neck pain or cervical radiculitis, cervical epidural steroid injections are a fast and relatively painless outpatient treatment option. Steroid injections are believed to be effective due to their anti-inflammatory qualities and their ability to stabilize nerve membranes. The majority of patients who receive cervical epidural steroid injections experience instant relief from their pain symptoms and can immediately resume normal daily activities.
- Bicket MC, Gupta A, Brown CH, Cohen SP. Epidural injections for spinal pain: A systematic review and meta-analysis evaluating the “control” injections in randomized controlled trials. Anesthesiology. 2013; 119(4):907-31.
- Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. American Society of Interventional Pain Physicians. Pain Physician. 2007;10(1):7-111.
- Kwon JW, Lee JW, Kim SH, Choi JY, Yeom JS, Kim HJ, Kwack KS, Moon SG, Jun WS, Kang HS. Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors. Skeletal Radiol. 2007;36(5):431-6.
- Huston CW. Cervical epidural steroid injections in the management of cervical radiculitis: Interlaminar versus transforaminal. A review. Curr Rev Musculoskelet Med. 2009;2(1):30-42.
- Manchikanti L, Cash KA, Pampati V, Wargo BW, Malla Y. A randomized, double-blind, active control trial of fluoroscopic cervical interlaminar epidural injections in chronic pain of cervical disc herniation: Results of a 2-year follow-up. Pain Physician. 2013;16(5):465-78.
- Pasqualucci A, Varrassi G, Braschi A, Peduto VA, Brunelli A, Marinangeli F, Gori F, Colò F, Paladini A, Mojoli F. Epidural Local Anesthetic Plus Corticosteroid for the Treatment of Cervical Brachial Radicular Pain: Single Injection Versus Continuous Infusion. Clin J Pain. 2007;23(7):551-7.
- Scanlon CG, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: More dangerous than we think? Spine. 2007;32(11):1249-1256.