Steroid injection is used by many pain management experts to reduce swelling and inflammation in the neck which eventually results in providing relief for neck pain. They can offer some tremendous benefits to neck pain patients in their initial phase of the treatment.
Also known as cortisone shots, pain doctors have been using these injections since the 1950s to provide short-term relief from chronic neck pain. It focuses on reducing inflammation in the nerves, joints, and other internal components and encourages recovery. Apart from the neck, it is often used to treat chronic pain in the following joints:
- Lower back
These injections are often used in combination with a local anesthetic. Cortisone offers longer-acting pain relief gradually while the local anesthetic offers short-term relaxation from pain. It is highly important to place the injection correctly in order to get the best results.
In this blog, we will look at some facts about corticosteroid injections that will make you understand what it is, how it is used, how it helps patients with neck pain, and who can receive them.
What Is Steroid Injection?
When our body feels stress, a steroidal hormone called cortisone is naturally produced by the body’s adrenal gland. The steroid injection uses a similar thing but synthetically produced, to offer pain relief for patients. Many have the misconception that corticosteroid is the same as an anabolic steroid which is usually used by athletes to illicitly improve their strength and muscle mass. The fact is, cortisone injections are much different than this and are completely legal.
Cortisone is not really a drug that can relieve pain. However, it manipulates our body’s inflammatory responses to the injuries. The major reason behind the usage of local anesthetic is its ability to suppress the discomfort caused to the body by cortisone itself. When the effect of local anesthetic fades, the location of the injection gets sore and patients may need to use ice packs or frozen bags to get some relief.
As long as neck pain is concerned, the pain doctors recommend such steroid injections if the pain is mainly caused by herniated discs or pinched nerves. In most cases, this treatment is tried when other initial treatments such as steroid medications do not offer the desired relief.
Steroids are used widely for their incredible anti-inflammatory properties.
Doctors inject them directly into the spinal nerve areas in the nerve block procedure. In epidural injections, the steroid is injected right into the spinal canal near the fluid-filled sac that surrounds the cord.
As mentioned earlier, this procedure cannot be completed without local anesthesia and medical experts such as radiologists use imaging tests such as X-rays to ensure the injection is being given in the right location. The time span of this procedure is usually 30 minutes or less.
Patients may experience pain relief from steroid injections for several weeks to a year or more. However, it may not work at all for some patients. Sadly, there is no process available to measure the potential effects of this procedure before it is given. The only good thing about this is steroids can have long-term effects on most patients.
Doctors suggest undergoing the steroid injection procedure just before patients begin their physical therapy program. It helps them to perform strength-building exercises without feeling any pain. If these injections fail to eliminate the neck pain, doctors may recommend surgical treatments.
How The Steroid Injection Is Used
In neck pain treatment, doctors directly inject the steroid into the inflammation region. Cortisone reduces the swelling in the cases of neck pain caused by strained muscles. Sometimes, pinched nerves lead to inflammation and cause neck pain. In such cases, the steroid reduces inflammation and relaxes muscles in the neck to offer relief.
Note that such steroid injection procedures are only considered when the initial treatment such as rest, over-the-counter or prescription medications, and physical therapies do not have any effect on the pain. Patients with neck pain receive steroid injections in combination with rehab and rest for the best outcomes. Post this procedure, patients need to avoid overuse of the neck as it can improve inflammation and ruin the benefits that steroid injections may provide.
The location for injecting the steroid injection is normally around the cervical spine or upper spine for neck pain. When the neck pain is so severe and it radiates to other body parts such as arms, the steroid injections are given in the same region — the cervical spine. Such radiating pain is medically known as radicular pain or radiculopathy.
Types Of Steroid Injections
Facet Joint Injections
Spinal bones (vertebrae) are connected to the spine through facet joints. Spinal movements and flexibility are looked after by these joints. Medical conditions such as spinal osteoarthritis can cause inflammation or irritation in the facet joints making them enlarged and thicker. This pinches into the neural foramen and presses the nearby nerves. This can be extremely painful. The facet joint injection, filled with corticosteroid and local anesthetics is directly injected into the affected joint. While the steroid reduced the inflammation in the joints and nerve roots, the local anesthesia lessened the discomfort and pain.
This procedure involves the fluoroscope to get the live imaging of the affected areas like joints and spine. This helps doctors to place the injection rightly into the facet joints. Most patients do not have any side effects of this and can go home the same day. They are good to resume their everyday activities one day after the procedure.
Epidural Steroid Injections
The spinal canal has a fluid-filled sac that surrounds the spinal cord and nerve roots. Neck pain and spinal stenosis patients can receive epidural steroid injections directly in this fluid-filled area of our spinal tunnel. Just Like facet joint injections, epidural steroid injections are also a combination of local anesthesia and corticosteroid. Both of these elements work together to reduce inflammation and relieve pain. Doctors may use x-ray videos to guide the needle to the exact location in the spinal tunnel.
The effects of epidural steroid injections start after 48 to 72 hours and they can take around a week to offer relief from pain. While these injections are not suitable for all the patients, they provide relief for a week or even months. There is no way to predict the effects of these injections on patients.
This procedure takes 30 minutes or less and can lead to some minor side effects for some patients such as soreness around the injection area. Patients can go home the same day and resume their work from the next day.
Nerve Root Block
A medical condition called bone spurs increases pressure on the nerve roots and can cause inflammation in the spinal canal. Even the damaged discs can leave the same effects on our spine and cause extreme pain. Nerve root block injections are given in such cases and injected right into the spinal canal. This procedure can also be used when there is no clear picture of the root of the pain. If the pain is gone after the pain, we can assume that the blocker nerves were the pain source.
Potential Benefits Of Steroid Injections For Neck Pain
It can be a bit difficult to summarize the potential benefits of the steroid injections as they depend on several variables such as:
- Additional treatments a patient has undergone or will undergo
- Duration of the symptoms
- Causes of symptoms
This list goes on and on. However, most patients experience more than 50 percent improvement in their neck pain conditions for at least 4 weeks. In some cases, patients can feel the relaxation for up to 6 months as well. Steroid injections have shown better results for the pain that radiates to arms than the pain that centralizes only in the neck. There isn’t any major difference between approaching techniques, whether it is interlaminar or transforaminal.
When steroid injections are part of a comprehensive treatment plan for neck pain patients, pain and overall satisfaction improve. The benefits are even better if these injections are used with physical therapy and medications.
Who Are The Candidates For Steroid Injections?
Steroid injections are a great option for those who have tried physical therapy and other medications earlier and did not feel any relief. It is also a good option if a patient wants to avoid surgical treatments. It has many potential benefits for patients suffering from neck pain, herniated discs, spinal stenosis, and other degenerative disc diseases.
Note that steroid injections are not the cure for the problem; however, they offer relief and overall satisfaction for the patients suffering from chronic pain issues. They make ongoing physical therapy and exercising easy and encourage muscle strength indirectly. The most important thing – it reduces irritation, swelling, and pressure on the nerve roots allowing sufficient time for the body to recover.
Steroid injections are a minimally invasive pain-reducing procedure and are excellent for neck pain caused by inflammation in the spinal nerves. Plus, it is a perfect option if you do not want to undergo costly surgery.
People who are currently taking a blood thinner or have an allergic reaction to cortisone should avoid this option. No matter what, make sure to discuss your medical history with your pain doctor before the steroid injection procedure. If you are a suitable candidate for this, you can definitely look forward to some relief from your neck pain.