Cervical epidural steroid injection Who it may help with neck and arm pain, what happens and what to expect after

Pain that runs from the neck into the arm has several possible causes, including a herniated or bulging disc, narrowing of the openings the nerves pass through from arthritis (foraminal stenosis), wider narrowing of the spinal canal, and problems that only mimic a neck nerve, such as a shoulder injury or a pinched nerve at the elbow or wrist. A physician examines your strength, reflexes and sensation and orders imaging such as an MRI, or an EMG/NCV nerve test, when it will help pin down the source. When an irritated nerve in the neck fits, a cervical epidural steroid injection is one option. Read more in herniated disc in neck.

Who a cervical epidural steroid injection may help

• Arm pain, numbness or tingling from an irritated nerve root in the neck (cervical radiculopathy)
• Pain from a herniated or bulging disc in the neck that has not settled with therapy and time
• Narrowing around the nerves from arthritis; see spinal stenosis
• People who want to avoid or delay surgery, or who need relief to keep up with physical therapy for neck pain

It is less useful for a stiff, achy neck without arm symptoms. That pattern has other causes and treatments; see chronic neck pain treatment and neck radiofrequency ablation.

What happens during the injection

1. You lie face down with your forehead supported; the skin at the base of the neck is cleaned and numbed
2. Using fluoroscopy (live X-ray), the physician guides a thin needle into the epidural space, commonly between the lower neck vertebrae
3. A small amount of contrast dye confirms where the medicine will spread
4. The steroid and numbing medicine are injected slowly
5. You rest for a short time while the team checks how you feel, then go home with someone to drive you

Tell your physician about blood thinners, diabetes and allergies before the visit. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.

Recovery and results

Most people go home within an hour and return to normal light activity the next day. Soreness at the injection site for a day or two is common, and the numbing medicine can make the arm feel heavy for a few hours. The steroid usually starts working within two to seven days. Relief can last weeks to months; if it helps but wears off, the injection may be repeated a limited number of times a year. Our guides to epidural steroid injection recovery and whether epidural injections work explain what to expect.

Risks and what to watch for

Serious complications are rare. Possible risks include a headache, a temporary rise in blood sugar in people with diabetes, facial flushing, infection, bleeding and, very rarely, nerve injury. Your physician reviews these with you first. Call right away for fever, worsening weakness, a severe headache that is worse when you sit up, or new numbness after the injection.

Therapy is part of the plan

An epidural calms pain; it does not change the disc or the joint. Use the relief to restart neck and shoulder exercises, posture work and, for some people, cervical traction. Physical therapy and spinal traction are offered at both our Brooklyn and Staten Island offices.

Related care at Precision Care Medical & Sports Performance

A cervical epidural steroid injection near you

Looking for an epidural injection near me for neck and arm pain? Precision Care Medical & Sports Performance evaluates neck pain at all three offices, where our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan examine you, review your imaging and decide whether a cervical epidural fits. Our Brooklyn pain management office on Shell Rd is close to Gravesend, Bensonhurst and Brighton Beach.

Our Staten Island pain management office on Richmond Rd serves New Dorp, Grant City and Oakwood. In Manhattan, the Precision Care Spine & Pain Center in Midtown Manhattan is convenient from the Financial District and the Upper West Side, and a direct ride from Harlem and Washington Heights. Request an appointment or call the office closest to you.

Questions patients ask

Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.

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