Procedures > Neck & Upper Back > Cervical Epidural Steroid Injections

Cervical epidural steroid injections reduce inflammation and decrease swelling of pinched nerves in the neck and upper back, or cervical spine, thus relieving pain.

Who is a candidate?

Patients who have pain due to:

  • Cervical radiculopathy—A pinched nerve in the neck that radiates pain into the shoulder, and sometimes down the arm and into the hand.
  • Spinal stenosis-A condition in which the spinal canal narrows and compresses the spinal cord and nerves.
  • A herniated cervical disc—A bulge or rupture in one of the shock-absorbing discs between the spinal vertebrae in the cervical spine (neck and upper back). When the filling leaks out of the disc, it can irritate sensitive nerve roots and cause pain that travels from the neck into the shoulders, arms and hands.

Dr. Steve Aydin and Dr. Sanjay Bakshi answer questions
about cervical epidural steroid injections

Who is a candidate for cervical epidural steroid injections?

We use cervical epidural steroid injections in several different settings:

  • When someone has a pinched nerve in the neck or upper back with pain radiating down their arm and more-conservative treatments like physical therapy or oral medications haven't worked.
  • When neck or upper-back pain prevents patients from getting back to work and enjoying their life.
  • When a patient is in too much pain to tolerate physical therapy and has not gotten enough pain relief from prescribed medications.

Do epidural steroid injections fix the cause of the pain?

Epidural steroid injections indirectly fix the cause of the pain. They do not change structural abnormalities such as herniated discs or spinal stenosis. However, epidural steroid injections do take away the resulting inflammation which is causing the nerve root to be irritated.

How, then, do steroid injections relieve pain?

Steroid injections can relieve pain by decreasing the swelling around pinched nerves. This helps calm the excitability of irritated nerves, which then lessens the transmission of pain signals to the brain.

Are the steroids used in pain management the same kind that some athletes use?

No. We use corticosteroids to help decrease inflammation and swelling and control pain. The steroids that some athletes use are anabolic steroids, which help to build muscle.

The corticosteroids we use at Manhattan Spine and Pain Medicine are in a category called glucocorticoids. Examples include prednisone, hydrocortisone, methylprednisolone and dexamethasone.

What is the epidural space?

The spinal cord is surrounded by spinal fluid kept in place by the dura-a tough sleeve that surrounds the brain and spinal cord and prevents the spinal fluid from leaking out. The prefix "epi" means over, so the epidural space is the space outside the dura. Epidural injections put medication into this space.

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