Cervical Epidural Injections

Neck and back pain have become one of the most common and difficult to treat medical conditions in our society today. Approximately 80 percent of adults will experience neck and back pain at some point in their lives. Often neck and back pain results in lost or low work productivity. The loss of one’s activity and lifestyle can ultimately lead to chronic pain and disability.
Epidural Injections are a very common treatment for neck, back and extremity pain.

The epidural space is an area of the spine where the nerves from the spinal cord pass to their end destination in the body (ie. shoulder, arm, hand etc.) If you have disc herniations, spinal stenosis, epidural fibrosis, post-laminectomy syndrome or other conditions involving the epidural space of the neck, you may have epidural inflammation and pain. Epidural injections with local anesthetics and steroid medication can reduce inflammation, restore normal size of epidural nerves and wash out any build up of toxic chemicals (ie. damaged disc material). Therefore the injection may eliminate your pain.

Breaking the cycle of the pain and spasms will reset the nerves to a more normal function, thus allowing one more freedom from daily discomfort. Activities of daily living will be improved. The injection is minimally uncomfortable and is well tolerated by most patients. Your doctor will use local anesthesia at the area of injection and you may receive intravenous sedation. Complications are extremely rare but may occur. You may wish to discuss these with your doctor in more detail.

You may do well with 1-2 injections but some patients require a series of 3-4 injections. You may also need occasional interval injections every 3-12 months depending on your diagnosis, pain level and function.

For certain types of neck pain, your doctor may suggest a cervical epidural injection.  With this treatment, medication is injected into the epidural space of the neck. The injection helps your doctor find the exact source of your pain. It can also help relieve your pain and dysfunction.

A cervical epidural injection may reduce swelling in the epidural space and therefore relieve pain.Preparation

In preparation of your injection, remember:

The injection is done in a hospital or surgery center. You’ll be asked to fill out some forms including a consent form. You will be examined and provided with an IV for fluid and medications.

During the Procedure To help you relax, medication may be given through the intravenous line. You will lie on an exam table on your stomach or side or sit in a chair. After twilight sleep is induced, the anesthesiologist will make sure you are comfortable and asleep.

Fluoroscopy will be used for guidance.

• The skin over the injection site is cleaned. Your doctor will inject a local anesthetic, which will numb the skin and subcutaneous tissues.
• Fluoroscopy (x-ray imaging) will help guide your doctor as to the exact injection site. A contrast “dye” may be injected in to the region to help obtain a better image.
• The cervical epidural injection is given which contains a long acting local anesthetic with steroid to reduce pain and inflammation.

Do not perform heavy lifting or engage in aggressive physical activity on the day of the procedure. After the Procedure

Commonly, you will be able to leave approximately an hour after the procedure. Have an adult driver take you home. As the anesthetic wears off, your neck may feel more sore than usual, which is normal. Rest and ice the area for 20 minutes on and 40 minutes off for the first day of the procedure. Steroids will begin to work in 2-3 days. Ask your doctor when it’s OK to return to work.

Call your doctor if you have a fever over 101 degrees F, nausea, severe headaches, increased arm weakness, problems swallowing or a severe increase in pain.

Complications are rare but may include:

The cervical vertebrae are part of the bony skeleton that supports your neck and head. They form the top part of your spine. The tunnel made by these vertebrae is called the spinal canal. The spinal cord runs through the spinal canal, inside a sac called the dura and the thecal sac. Nerves branch off the spinal cord and exit through the vertebrae. Pressure on one of these nerves may cause them to become inflamed (irritated and swollen). An inflamed nerve in your neck may cause neck pain that may also be felt in your head or arms.

You will be scheduled for a follow-up visit after your injection to discuss results. At that time, a series of injections may be scheduled or additional therapies may be discussed. Nutritional supplementation coupled with wellness products may be helpful in treating this condition. Ask your doctor for a program.