A cervical epidural steroid injection (CESI) is an injection of corticosteroids (similar to cortisone) into the space just outside the covering of the spinal cord (the dura) in your lower back. These injections are used for spinal nerve inflammation that is causing pain and discomfort in the neck, arms and head. The spinal cord travels from the brain to the waist in a tunnel in the back part of the spine. About every inch along the way, the spinal cord gives off branches (spinal nerves) to the right and left. These spinal nerves carry sensations and pain signals from the various parts of the body back to the brain. When nerves are inflamed or constricted, they can cause pain in the region. Common symptoms for CESI include neck pain, headaches, herniated discs, degenerate disc disease, radiculopathy or radiculitis, and spinal stenosis.
The most conservative treatment involves ice, rest, anti-inflammatory medication, neuropathic medication and physical therapy. When these measures are not sufficient, cervical injections are often an option to reduce the pain and improve mobility. It can also reduce or eliminate the need for pain medications and avoid surgery. Corticosteroids are very potent anti-inflammatory medications that work best when they are injected into the area where the inflammation is occurring. Because the spinal nerves pass directly through the epidural space, a CESI allows the medication (steroid) to come into direct contact with the inflamed spinal nerves, reducing the pain associated with the inflammation.
Potential side effects or risks may include soreness as the injections site and the procedure may take 3-7 days to have an affect. Patients sometime complain of a red rash that is temporary. Patients who have diabetes can have an increase in their blood sugar due to the steroid and should pay close attention to their blood sugars. Other possible side effects are discussed with patients who are candidates for CESI prior to having the injection.