A cervical epidural steroid injection goes into a space near the spine and has anti-inflammatory effects. But it’s not recommended for everyone with chronic pain.
What Is A Cervical Epidural Steroid Injection?
A cervical epidural steroid injection is a shot to relieve chronic pain. The shot goes into a space near the spine and has anti-inflammatory effects. It’s best for pain that’s the result of nerve injury or damage.
Cervical epidural injections may have to be repeated for ongoing pain relief. Insurance and some government programs may cover the costs. The out-of-pocket expenses for those without coverage are similar to the costs of conservative pain treatment.
There are two types of cervical epidural injections: interlaminar and transforaminal. The difference is where the injection enters the body. Interlaminar shots enter between the layers of the vertebrae, whereas transforaminal injections go into the side of the spine at the nerve root.
What Does A Cervical Epidural Steroid Injection Treat?
Cervical epidural injections treat pain from cervical radiculopathy, the medical term for a pinched nerve. A pinched nerve is when you have radiating numbness, pain, burning, or a “pins and needles” sensation.
Many people experience a pinched nerve when there’s inflammation or pressure at the nerve root close to the spine. Cervical radiculopathy can affect any nerve whose root is at the spine. That means it can be the cause of pain in many areas of the body, including the neck and lower back. It can also affect the shoulder and arm.
A pinched nerve can be from:
- a sudden injury such as a herniated disc
- ongoing conditions such as arthritis
- wear and tear changes in the body over time
Cervical Epidural Steroid Injection Success Rates
There’s some research to support that some people do get pain relief from cervical epidural injections.
A 2020 review of studies of cervical transforaminal epidural steroid injection studies found that about 50% of people get at least 50% pain relief. However, the studies didn’t have control groups for comparison, so the evidence of effectiveness is considered low quality.
A small 2019 study found at a 2-year follow-up that of 34 people who received a cervical transforaminal epidural steroid injection after disc herniation, 11 needed more injections, and 4 required surgery.
Cervical Epidural Steroid Injection Side Effects And Risks
Both interlaminar and transforaminal injections come with potential side effects and risks. The most common side effects are:
- neck pain
- headache
- insomnia
- fainting (vasovagal reaction)
Other reported risks may occur less frequently.
Possible risks of interlaminar cervical epidural injections are:
- puncture of the dura (membrane around the spinal cord)
- injury to nerve root
- hematoma (swelling of clotted blood)
- temporary burning or prickling sensation (paresthesias)
- temporary blindness
- infection near the spine (epidural abscess)
- spinal cord injury
- paralysis
- death because of embolic stroke or perforation of vertebral artery
Possible risks of transforaminal cervical epidural injections are:
- temporary increase in radicular (nerve) pain
- puncture of the dura (membrane around the spinal cord)
- temporary lightheadedness
- temporary amnesia (memory loss)
- paralysis
- injury to the vertebral artery
- stroke (cerebellar infarction)
- death because of stroke or perforation of vertebral artery
A 2018 review of the risks of cervical epidural steroid injections stated that the risks of the procedure are underreported, so they may occur more frequently than thought.
Cervical Epidural Steroid Injection Procedure
It would help if you didn’t have to stay overnight in a hospital for a cervical epidural steroid injection. The procedure itself takes about 15 to 30 minutes, and you should be observed for 15 to 20 minutes afterward.
Before the procedure
A doctor or healthcare professional should discuss the risks of the procedure with you before proceeding. They’ll then review all medications used, and you may be told to avoid blood thinners. They’ll also review your known medication allergies and ensure you don’t have known allergies to the anesthetic or steroids used.
You’ll lie down on a table, either on your stomach or on your side, or sit up in a curled position.
During the procedure
The doctor will clean the skin and numb the area with a local anesthetic. They’ll insert the needle into your back using X-ray imaging to guide them to the right spot. Once the needle is in place, the doctor will inject the steroid solution.
After the procedure
The doctor will remove the needle. You’ll stay for a short period after the procedure for monitoring. You may be discharged after 15 to 20 minutes of observation.
What To Expect After Cervical Epidural Steroid Injection
You should be able to go home on the same day as the procedure. You can expect to have pain relief within 1 to 3 days, but it may take as long as 7 days.
Who’s A Candidate For A Cervical Epidural Steroid Injection?
You may be a candidate for a cervical epidural steroid injection if you have symptoms of pinched nerve pain. This may include radiating pain, numbness, tingling, or burning.
You should’ve had these symptoms for at least 6 to 8 weeks without finding relief through conservative measures such as:
- over-the-counter pain medication
- physical therapy
- activity modification
How Much Does A Cervical Epidural Steroid Injection Cost?
A 2019 study found that the direct cost to people for an epidural steroid injection was $1,406.87 on average. This was compared with $1,194.57 for those who received conservative management of physical therapy and pain medication. Those in the conservative management group missed many more work days, leading to higher indirect costs than those for the people who received the injection.
The injection may be covered by Medicare if it’s medically necessary. It may also be covered under state workers’ compensation programs.
Frequently Asked Questions About Cervical Epidural Steroid Injections
Here’s some essential information about cervical epidural steroid injections.
How long does it take for a cervical epidural steroid injection to work?
You should have some pain relief within a few days or up to 1 week. However, some people don’t experience any pain relief.
How long does a cervical epidural steroid injection last?
Pain relief from the injection can last from a few days to a few months. For ongoing pain relief, you may need to repeat injections and combine them with other forms of pain management.
Can you have increased pain after a cervical epidural steroid injection?
A temporary increase in pinched nerve pain is one possible risk of transforaminal epidural steroid injection. Interlaminar injections have temporary burning or prickling as a possible risk.
Cervical epidural steroid injections can help relieve pain associated with pinched nerves. Many people need to have injections repeated and also use other forms of pain management to improve symptoms. The injections may be covered by insurance programs, such as Medicare, and workers’ compensation.
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens, and New Hyde Park – Long Island. Call the Queens office at (718) 215-1888 or (516) 419-4480 for the Long Island office to arrange an appointment with our Interventional Pain Management Specialists, Dr. Jeffrey Chacko or Dr. Sonny Ahluwalia.
