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FAQs on Cervical Epidural Steroid Injections in Phoenix, Arizona

 

Chronic neck pain is a real problem among adults, with a prevalence of around 40%. Cervical epidural steroid injections (ESIs) are used to manage chronic pain of the neck, head, and upper extremities.

What is the epidural space?

Surrounding the spinal cord and nerves is a protective covering called the dura. The area around the dura is called the epidural space. The cervical spine has seven vertebrae, which are the irregular shaped bones. The discs of the spine can tear, herniate, or bulge, which produces neck pain, arm pain, and headaches.

What conditions are treated using cervical ESIs?

Cervical ESIs are used to stop pain associated with compression or irritation of the nerve roots in the cervical spine, to stop radiculopathy pain, and to ease discomfort associated with head, neck, or extremity problems. Common indications for cervical epidural steroid injections include:

  • Spinal stenosis, which is a degenerative disorder where the spinal canal narrows causing compression or irritation of nearby nerve roots.
  • Herniated discs, where the fibrous intervertebral discs between each vertebra cause compression on nearby nerves.
  • Spondylosis, where osteoarthritis develops within a facet joint (joints of the posterior spine) and is caused by bony protrusions or canal space narrowing.

What types of medications are used in the cervical epidural steroid injection?

Corticosteroids are used to reduce irritation and inflammation, and an anesthetic is often added to disrupt the transmission of pain signals carried to the brain by nerves.

How is the procedure performed?

With the interlaminar approach, the needle is inserted on both sides of the affected vertebrae, and with the transforaminal, the needle is inserted directly at the affected nerve. During the cervical ESI procedure, the medication is injected into the epidural space, which surrounds the spinal cord within the cervical (neck) region. After the skin is cleaned, the doctor uses an anesthetic to numb the area. The procedure needle is inserted under real-time x-ray, which then allows for the correct placement of needle and medication. After injecting, the procedure needle is removed, and a bandage is applied.

How do I prepare for a cervical epidural steroid injection?

The doctor will first meet with you to review your current health status, evaluate what has helped you in the past, and make a decision whether the procedure will benefit you. During the consultation, disclose with the doctor what medications you are taking, as certain blood thinning agents must be held for several days beforehand.

What happens after the procedure?

Expect to have some soreness of the injection site after the cervical ESI. You will be monitored in the procedure area for a short time by a nurse. Some patients report temporary numbness and weakness of the arms, which resolves after a few hours. Most people can resume normal activities in 1-2 days following the procedure.

What are the benefits of a cervical ESI?

Cervical ESI is a relatively painless procedure. In a recent clinical trial, 75% of patients with cervical radiculopathy and neck pain reported immediate relief after this injection. In addition, the procedure was found to be more beneficial than using opioid narcotics, physical therapy, or massage. However, these measures often are used in conjunction with cervical ESI.

What outcome can I expect after the cervical ESI?

Many observational studies show that the cervical ESI provides significant pain relief that lasts 6 months or more for around 60% of patients. In addition, another clinical study found that pain scores decreased by 87% at 4-6 months following a cervical ESI using steroid/lidocaine combination. Regarding the research, it shows that chronic neck pain is relieved effectively and safely with this procedure.

Resources

Castagnera L, Maurette P, Pointillart V, Vital JM, et al. (2004). Long-term results of cervical epidural steroid injection with and without morphine in chronic cervical radicular pain. Pain, 58:239–43. doi: 10.1016/0304-3959(94)90204-6.

Manchinkant L, Cash KA, Pampati V, & Malla Y (2014). Two-Year Follow-Up Results of Fluoroscopic Cervical Epidural Injections in Chronic Axial or Discogenic Neck Pain: A Randomized, Double-Blind, Controlled Trial. Int J Med Sci, 11(4), 309-320.

 

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