Cervical Epidural Steroid Injections

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Cervical Epidural Steroid Injections 2016-11-04T09:29:35+00:00

What is a Cervical Epidural Steroid Injection?

Cervical Epidural Steroid Injections performed by Las Vegas, Summerlin, and Henderson Nevada’s Top Pain Doctors

Between 50 and 80% of adults will experience some form of neck and back pain over the course of their lifetime. Specifically in terms of chronic neck pain and cervical radiculitis, the treatment of choice has been cervical epidural steroid injections.

This treatment is highly regarded as a quick, effective treatment for reducing or eliminating cervical nerve pain. In fact, most patients are able to benefit from the injection’s immediate effect of reducing their pain. These patients are able to almost immediately resume daily activities. One study reported that in nearly 75% of the sample experienced, there was a 50% improvement in daily functioning following treatment.

Cervical Epidural Steroid Injection – Performed Live, Watch Now!

Cervical radiculitis, a condition commonly treated using cervical epidural steroid injections, is caused by an increase in pressure on the nerves located in the neck. In addition, these nerves become irritated as they exit the spinal canal. The pain, which begins at the cervical spinal nerves, then radiates through the nerves as they extend out from the spinal canal. This results in feeling as though the pain is radiating down the patient’s arm. Numbness and weakness associated with the pain may also occur.

Spinal CordWhile the precise mechanisms of action are largely unknown, it is primarily believed that steroid injections serve to reduce nerve pain through their anti-inflammatory effects. Indeed, steroids have other properties beyond the anti-inflammatory characteristics that also likely play a role in their effectiveness. For example, steroids stabilize nerve membranes and inhibit the conductance of ions, both of which are also viable explanations for the relief of pain symptoms.

A recent meta-analysis examined the effectiveness of the cervical epidural steroid injections over the course of the last ten years. Findings from this study echo previous work supporting the use of steroid injections for managing pain.

Long-term effects of cervical epidural steroid injections, however, are not as clear. Some patients have experienced long-term benefits from the injection, while others have not. Given that these injections are safe, patients who did not enjoy long-term relief from their pain are able to receive multiple treatments over the course of a year for managing their pain.

How is a Cervical Epidural Steroid Injection Performed?

Cervical Epidural Steroid InjectionWithin the spinal canal, the spinal cord is surrounded by the cerebrospinal fluid (CSF), which acts as protective padding for the nerve bundle of the spinal cord. The spinal cord and the CSF are held in place within the spinal canal by a durable membrane. The cervical epidural steroid injection is given in the epidural space, which is the area just outside of this membrane. Only topical anaesthetic is used on the surface of the skin prior to the injection. Using an x-ray as a guide for proper placement into the epidural space, the physician inserts the needle into the vertebrae. Contrast dye is used to test for proper placement of the needle prior to injecting the steroids, as well as appropriate distribution of the solution within the area of interest. Once proper placement has been confirmed, the physician administers the steroids. Moreover, steroids are administered only in areas with the most inflammation. This reduces the amount of exposure the patient has to the steroids.

Cervical epidural steroid injections are non-surgical, easy to administer, and are generally painless. They can be administered within an outpatient setting. Further, most patients treated with steroid injections are expected to feel an immediate reduction or elimination of their pain following the treatment. According to a study examining the use of multiple injections, there is support for the benefit of administering multiple injections over the course of the year to patients whose pain initially only moderately responded to the steroid injection.

Conditions Related To Cervical Epidural Steroid Injections

Clavicle NervesSteroid injections are commonly utilized among anaesthesiologists for the treatment of nerve pain near the head and neck resulting from compression of the nerve fibers. Other conditions that are also treated with steroid injections include:

  • Herniated disk
  • Nerve compression (specifically, in the neck)

Conclusion

Cervical epidural steroid injections are a quick and relatively painless treatment for nerve pain associated with the compression and irritation of the nerves near the neck. These nerves extend out from the spinal canal, which causes the pain to feel as though it is radiating down the patient’s arm. Steroid injections are believed to be effective due to their anti-inflammatory qualities but the literature is still unclear. Many patients who receive the steroid injection are able to feel immediate relief from their pain and return to their daily lives.

At Nevada Pain our goal is to relieve your pain and improve function to increase your quality of life.
Give us a call today at 702-912-4100.

References

  1.  Bicket MC, Gupta A, Brown CH, Cohen SP. Epidural injections for spinal pain: A systematic review and meta-analysis evaluating the “control” injections in randomized controlled trials. Anesthesiology. 2013; 119(4):907-31.
  2.  Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. American Society of Interventional Pain Physicians. Pain Physician. 2007;10(1):7-111.
  3.  Kwon JW, Lee JW, Kim SH, Choi JY, Yeom JS, Kim HJ, Kwack KS, Moon SG, Jun WS, Kang HS. Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors. Skeletal Radiol. 2007;36(5):431-6.
  4. Huston CW. Cervical epidural steroid injections in the management of cervical radiculitis: Interlaminar versus transforaminal. A review. Curr Rev Musculoskelet Med. 2009;2(1):30-42.
  5. Manchikanti L, Cash KA, Pampati V, Wargo BW, Malla Y. A randomized, double-blind, active control trial of fluoroscopic cervical interlaminar epidural injections in chronic pain of cervical disc herniation: Results of a 2-year follow-up. Pain Physician. 2013;16(5):465-78.
  6.  Pasqualucci A, Varrassi G, Braschi A, Peduto VA, Brunelli A, Marinangeli F, Gori F, Colò F, Paladini A, Mojoli F. Epidural Local Anesthetic Plus Corticosteroid for the Treatment of Cervical Brachial Radicular Pain: Single Injection Versus Continuous Infusion. Clin J Pain. 2007;23(7):551-7.
  7. Scanlon CG, Moeller-Bertram T, Romanowsky SM, Wallace MS. Cervical transforaminal epidural steroid injections: More dangerous than we think? Spine. 2007;32(11):1249-1256.

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