Cervical Epidural Steroid Injections: What It Is, Benefits, Risks & Side Effects (2024)

What is a cervical epidural steroid injection?

A cervical epidural steroid injection (cervical ESI) is an injection of anti-inflammatory medicine — a steroid or corticosteroid — into the epidural space around the spinal nerves in your neck.

The main goal of cervical epidural steroid injections is to help manage chronic pain caused by irritation and inflammation of the spinal nerve roots in your neck (the cervical region of your spine) due to certain conditions or injuries. This type of chronic pain is called cervical radiculopathy, which can radiate down from your neck to your shoulders, arms and/or hands.

“Cervical” comes from the Latin word “cervix,” which means “neck.” In the case of cervical ESIs, the injection is in your neck, not your cervix. The cervix, the narrow passage forming the lower end of the uterus, is called so because it’s a neck-like passage.

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How does a cervical epidural steroid injection work?

Healthcare providers use cervical epidural steroid injections (cervical ESIs) for chronic pain management. Your provider injects a steroid or corticosteroid medication into the epidural space around the spinal cord in your neck.

The neck region of your spine is called the cervical spine. This region is made up of seven vertebrae. Your vertebrae are the 33 individual, interlocking bones that form your spinal column, which runs from the base of your skull to your tailbone. These bones help protect your spinal cord from injury. Between the vertebral bones are disks that provide cushioning for your vertebrae and flexibility for you.

The seven vertebrae in your cervical spine are named C1 through C7 from top to bottom. The cervical vertebrae have several important roles, including:

  • Protecting your brain stem.
  • Protecting your spinal cord.
  • Supporting your skull.
  • Allowing you to move your head.

Your spinal cord is a very important bundle of nerves that runs from your brain to your lower back. Your spinal cord acts like a highway that connects the nerves located all over your body to your brain so that your brain can send signals and communicate with the rest of your body.

Sometimes, nerve roots that are attached to the cervical region (neck region) of your spinal cord can become pinched or inflamed. This can happen, for example, if you have a herniated disk. The inflamed nerves can cause pain, and the pain may radiate down your shoulder and/or arm.

During a cervical epidural steroid injection procedure, your provider injects a steroid into the epidural space around your spinal cord. The epidural space surrounds your spinal cord like a sleeve and contains the following tissues:

  • Fat.
  • The dural sac.
  • Spinal nerves.
  • Blood vessels.
  • Connective tissue.

The steroid coats the irritated nerve(s) that are causing your pain and works to reduce swelling and pressure on the nerves. The steroid allows the nerve(s) time to heal.

Cervical epidural steroid injections most often lead to temporary pain relief, but some people do not experience pain relief from the injection.

What are cervical epidural steroid injections used for?

Healthcare providers use cervical epidural steroid injections to manage a type of chronic pain known as cervical radiculopathy, which is caused by spinal nerve root inflammation and irritation in your neck. Cervical radiculopathy can cause the following symptoms, which can radiate down from your neck to your shoulder, arms and/or hands:

  • Pain.
  • Numbness.
  • Muscle weakness.
  • Tingling.

Many conditions can irritate your spinal nerve roots in your neck and cause cervical radiculopathy, including:

  • Cervical herniated disk: This condition is also commonly called a slipped, ruptured or bulging disk. It’s one of the most common causes of neck pain. Disks have soft, gel-like centers and a firmer outer layer. Over time, the outer layer weakens and can crack. A cervical herniated disk happens when the inner substance pushes through a crack in one of the disks between two vertebrae in your neck. The leaked material may press on and pinch nearby spinal nerves.
  • Cervical degenerative disk disease: This condition happens when the cushioning in between the vertebrae in your neck begins to wear away. A degenerated disk could cause local inflammation in your spinal nerve roots.
  • Cervical osteoarthritis (cervical spondylosis): This condition involves changes to the bones, disks and joints in your neck caused by the normal wear-and-tear of aging. Cervical osteoarthritis can lead to narrowing of the interior of your spinal column in your neck or in the openings where spinal nerves exit, which can cause inflammation and irritation to the nerves.
  • Cervical spinal stenosis: This condition is the narrowing of one or more spaces within your cervical spine (your neck). Less space within your spine reduces the amount of space available for your spinal nerve roots. A tightened space can cause the nerves to become irritated or pinched, which can lead to neck pain.

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How common are cervical epidural steroid injections for pain management?

Cervical epidural steroid injections are a common form of therapy for certain causes of chronic neck pain. Cervical radiculopathy affects approximately 1 in 1000 adults per year, and neck pain is the fourth leading cause of disability in the United States. Over the past decade, the rate of cervical ESIs has doubled among people who have Medicare (the federal health insurance for people who are 65 years or older) in the United States.

Cervical Epidural Steroid Injections: What It Is, Benefits, Risks & Side Effects (2024)
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