This procedure is a common treatment option for those living with severe neck pain accompanied by pain, numbness, weakness, or altered sensations in the arms, shoulders, or scapula. It is also one of the most effective treatments for cervical radiculitis and other sources of chronic neck pain. 

During the procedure, a healthcare professional will inject cortisone into the epidural space in your spine. The epidural space is the area between the dura mater and the vertebral wall at the bottom of your spine. It contains fat, veins, arteries, spinal nerve roots, and lymphatics. Steroid injections into the epidural space can help alleviate pain in your cervical, thoracic, or lumbar spine, depending on where the healthcare professional injects the steroids. 

Conditions treated

A cervical epidural steroid injection treats pain in the cervical spine caused by:

• Herniated disc
• Degenerative disc disease
• Osteoarthritis
• Spinal stenosis
• Radiculitis 
• Radiculopathy
• Spondylosis 

Benefits

• Pain relief
• Regaining mobility in cervical spine
• Short recovery period compared to surgery

Procedure

Before the procedure, your healthcare provider may ask you to change your medication schedule, especially if you take blood thinners or immunosuppressant mediation. This can help reduce your risk of complications, such as infection. Inform your doctor of any past issues with contrast dye, allergies to medications, or complications arising from anesthesia. Tell your doctor about any medication you take, such as over-the-counter pain relievers, supplements, and prescription medication. Inform them of any medical conditions, even if you are still in the diagnosis process for one, and if you are or suspect you are pregnant. Your complete medical history will help your medical professional create an effective, educated decision regarding your treatment plan. 

On the day of your procedure, your healthcare professional may tell you not to eat or drink anything for several hours before the procedure. If you experience any cold or flu symptoms, contact your doctor, as you may need to reschedule your injection. 

The entire epidural steroid injection process lasts approximately fifteen to thirty minutes. Your healthcare provider performing the procedure will ask you to lie on the table on your stomach or side before administering a local anesthetic to the skin surrounding your epidural space. You may receive anesthesia via an IV, depending on your pain tolerance. Using x-ray guidance and contrast dye, the medical professional will then insert the needle into the epidural space of the spinal canal before injecting the cortisone steroid solution. 

After the procedure, you will remain in an observation room for about thirty minutes to an hour to ensure there are no immediate reactions to the medication. 

Recovery

Once discharged, you should rest for the remainder of the day. You can typically return to normal activities the next day, but your healthcare provider will provide you with specific instructions. You should have someone else drive you home.

You may notice an increase in back pain at the site of the injection over the next two to three days. This is completely normal and will dissipate within a few days. If the pain becomes unbearable, you can place an ice pack over the injection site or take over-the-counter pain relievers. You may feel numbness in your arms, but it will go away within a few hours. 

The majority of patients undergoing this procedure report experiencing at least partial pain relief. Some feel pain relief immediately following the procedure, while others’ pain relief began about a week afterward. If you have not felt any pain relief or experienced a drastic increase in pain after two weeks, contact your medical professional.

Risk

While epidural steroid injections are generally safe procedures, there is always a risk associated with it. Your doctor has weighed the risk against the benefits to determine this procedure is right for you. If you have any concerns related to the procedure’s risks, talk to your doctor. 

Common side effects of steroid injections include:

• Elevated blood sugar
• Facial flushing
• Insomnia
• lightheadedness
• Mood swings
• Water retention
• Weight gain

Major complications occur in less than one percent of epidural steroid injections and may include:

• Allergic reaction to anesthesia or steroids
• Bleeding 
• Headache from accidentally inserting needle into the spinal cord
• Infection
• Nerve damage