Cervical Epidural Steroid Injections

This procedure is used to treat swollen and inflamed spinal nerve roots often referred to as a "pinched nerve." The spinal nerves come from the spinal cord and exit the backbone to provide sensation to different parts of the body. Occasionally something rubs or irritates these nerves where they exit the backbone causing them to be swollen and inflamed. The source of irritation may be a ruptured, herniated, or bulging disc.

Another source may be Spinal Stenosis, where arthritis of the spine, bone growth, or hardening of the ligaments begins to close the openings in the spine through which these nerves exit. Common presentations associated with this inflammation of the spinal nerves in the neck or cervical spine include:

  • Pain in the neck or shoulders
  • Pain down one or both arms
  • Numbness or tingling of your shoulders, arms, or hands
  • Weakness in one or both shoulders, arms, or hands

With epidural steroid injections, a steroid is injected into an area in the back of your neck called the epidural space. The epidural space extends through the spinal canal from your head to your tailbone. As the spinal nerves pass through the epidural space, they are bathed in this steroid (a solution of anti-inflammatory medicine). Within a few days after the injection, the medicine should reduce the swelling and inflammation of these nerves and thereby offer pain relief.

You will probably be asked to return two weeks after your first injection. If all of your pain or numbness has been relieved, you will not need another shot at that time. Most often, however, the first injection will relieve most, but not all of your pain or numbness. At that time (2 weeks after the first injection) your doctor may suggest a second epidural steroid injection. Occasionally you may require a third injection two weeks after the second one. After a series of three injections, you have reached the maximal effect of the cortisone.