The Science Behind Cervical Epidural Steroid Injection

Cervical epidural steroid injection (CESI) is a procedure used to relieve pain caused by a pinched nerve in the arm, neck, or shoulder.

It also aids in treating conditions that lead to inflammation of one or more cervical spine nerve roots. This occurs when one of the nerve roots in the neck is compressed and gets inflamed. The pain will then travel to the shoulder then down to the arm and hand.

It’s possible to have injections of cortisone steroid medicine into the surrounding area to reduce the pain and swelling of the affected nerves.

The relief experienced is only short-term, though. It’s reported that about 40% to 84% of patients given CESI experienced only partial relief from pain.

As such, physical therapy is required to achieve long-term relief or another epidural injection at a future date.

So, why might you need a cervical epidural steroid injection in the first place?

Conditions That Will Require CESI

  1. Cervical degenerative disc disease
  2. Cervical herniated disc
  3. Cervical osteoarthritis
  4. Cervical spinal stenosis

Cervical Degenerative Disc Disease

This is considered as a common cause of neck pain.

It is due to the breaking down of the cushioning discs at the cervical spine caused by wear and tear.

CDDD can be genetic. It can also be triggered by a neck injury.

Cervical Herniated Disc Disease

Typically originating from a neck injury or trauma, cervical herniated disc disease sometimes causes different types of pain while sometimes there are no symptoms at all present.

Common manifestations of this condition are arm and hand numbness or weakness. It starts spontaneously and without warning.

CHDD commonly occurs when the nucleus pulpous (gelatinous inner disc material) ruptures and bulges through the outer cervical disc wall.

Cervical Osteoarthritis

Cervical osteoarthritis is also known as neck arthritis.

This condition occurs when the protective cartilage of the joints starts to break down and becomes painful and swollen.

Symptoms include:

  • Grinding or popping sensation when turning your head
  • Headaches
  • Loss of balance
  • Muscle spasms at the neck and shoulders
  • Trouble walking

Cervical Spinal Stenosis

Also called cervical stenosis, CSS happens when the neck’s spinal canal narrows because of trauma or degenerative changes.

The spinal canal becomes too small for the nerve roots and spinal cord.

Other factors include the following:

  • Excessive bone growth due to degenerative arthritis
  • Shorter than normal pedicles (bones from the sides of the canal)
  • Ossification and increase in size of the ligament
  • Rheumatoid arthritis


Since this is a safe procedure when done by a medical professional, the potential risks involving CESI are extremely rare.

Nevertheless, in rare cases you might experience:

  • Allergic reaction to the medication
  • Bleeding
  • Infection
  • Nerve damage
  • Prolonged Increase in pain
  • Spinal headache

Check with your doctor immediately if you experience any of the above side effects.

So far, so good. How can you go about having a cervical epidural steroid injection, though?


  • In preparation, you will lay face down and your doctor will then numb the injection site with an anesthetic solution
  • A fluoroscopy – this is X-ray guidance – and contrast dye are used to pinpoint the exact location where the needle should be positioned. The optimum spot is the spinal canal’s epidural space
  • With the needle is positioned, your doctor will administer a solution of cortisone steroids into the epidural space
  • A whole day’s rest is recommended post-procedure
  • CESI will provide at least 5 days of total pain relief

Final Thoughts

Well, we hope we’ve cleared up some of the technical stuff behind the remarkably effective procedure of cervical epidural steroid injection.

If you have any questions at all, feel free to get in touch any time.

You can schedule an appointment online or you can call us at 480-550-9393.