A cervical epidural steroid injection is a treatment method for pain in the neck and the upper region of the back. Upper back and neck pain reportedly affects 50-80% of adults at some point in their lives. There are numerous conditions that may cause neck and upper back pain such as cervical radiculitis, a herniated disc, strained muscles, and pinched nerves.
Cervical radiculitis occurs due to excessive pressure that is placed on spinal nerves, especially in the neck region, causing the nerves to become irritated and inflamed. The inflamed nerves extend from the spinal cord into various areas of the body and, because nerves are responsible for pain signal transmission, damaged nerves can result in chronic pain. Patients who have cervical radiculitis typically report experiencing sharp pains that shoot down one of the arms as well as weakness and numbness in the extremities.
One of the most effective forms of treatment for cervical radiculitis and chronic neck pain is a cervical epidural steroid injection. Research shows that an epidural steroid injection can rapidly reduce pain and completely alleviate pain for some individuals. The mechanism of action for steroid injections is still being studied, but it has been proposed that the medication, particularly the steroid that is injected, targets inflammation. Steroids also have additional useful properties that make them especially effective, which include an ability to promote the stability of the membranes surrounding the nerves and to hinder the conduction of ions. These processes are associated with reduced pain.
A meta-analysis study that focused on reviewing clinical reports regarding the effectiveness and safety of steroid injections, included data that was obtained over a span of ten years. The results showed strong support for the administration of epidural steroid injections to treat chronic pain.
The effects of steroid injections are generally long-term, but the mechanism that is responsible for this effect is still unclear. It has been concluded, however, that repeated injections that are performed over a one-year period can improve the long-term effects of the injections.
In order to understand the injection procedure and where the medication is injected, a brief description of the spinal region will first be explained. The spinal region includes a column of individual bones, called vertebrae, that encase and protect the spinal cord. A vast number of nerves extend out from the spinal cord to the rest of the body. The spinal cord is held in place by a strong membrane. Directly outside of the membrane is a region known as the epidural space, where nerve roots are located. This is the area in which steroids are injected if nerves become pinched, damaged, or inflamed.
Before the injection procedure begins, topical anesthesia is applied to the skin. Next, in order to prevent healthy nerve roots from being exposed to too much medication, the physician will use imaging technology such as fluoroscopy to guide the insertion of the needle and to confirm its correct placement in the epidural space. In addition, contrast dye is typically injected in order to observe where the medication will be administered and to ensure that it will be properly distributed throughout the targets areas. The administration of steroids and an anesthetic such as Lidocaine directly onto the nerves roots results in dramatic or complete pain relief. The steroid decreases inflammation, while the anesthetic disrupts pain signal transmission.
A cervical epidural steroid injection is a non-surgical, outpatient procedure that can be quickly performed. Patients who receive epidural steroid injections typically experience an immediate decrease in their level of pain or complete pain relief. If the pain relief after the first injection only lasts for a short period, then the injection can be repeated several times during a one-year time frame.
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