Adam Sewell MD


Cervical epidural steroid injections (CESIs) are one of the most commonly used treatments for chronic neck pain and cervical radiculitis (radiating spinal pain). Headaches and cervical spinal stenosis may also benefit from this treatment.

Cervical radiculitis is a result of nerve compression in the neck, also known as the “cervical spine”, and it radiates down the length of the arm or into some other location. The pain center actually stems from the cervical nerves in the spine and cause irritating and inflammation. This can results in pain, numbness, or weakness, especially, when a cervical disk is bulging. Cervical radiculitis can be caused by spondylitis and arthritis of the facet joints. Both issues can be effectively resolved with CESIs (cervical epidural steroid injections).


With CESIs, a steroid is injected into the epidural space in the cervical canal. This is where the irritated and inflamed nerve roots reside. The injection includes a long-lasting steroid and a local anesthetic (usually, Lidocaine or Bupivacaine). The steroid reduces the inflammation, while the other medication numbs the area and prohibits some of the pain spasm cycle. The entire procedure usually takes less than 15 minutes.


Cervical steroid injections are simple and relatively painless. Most people, more than 70%, experience immediate pain relief from the procedure. If pain relief is only moderate after the first injection, up to two more can be administered at later dates. Subsequent injections are usually needed to experience complete relief.

For many people, cervical steroid injections cause rapid relief of symptoms, which allow them to become active again. The pain relief achieved from this treatment often allows patients to resume their normal daily activities within a short time, even in more treatments are needed to maintain the relief.


As with all procedures, there are risks with cervical epidural steroid injections. However, they are low. It is a non-surgical pain effective pain treatment, but it can cause Cervical epidural steroid injections do have risks, but they are typically low. This pain treatment is considered an appropriate non-surgical treatment for many patients who suffer from neck pain and headaches. Complications of the injection can include bleeding, infection, headaches, and nerve damage. The medications used can also cause pharmacological complications, like anaphylaxis, in the rare case that an individual has an allergy to them or an ingredient. Additional pharmacological risks are – high blood sugars, decreased immune response, and the potential for weight gain, as with all steroids.

Along with proper technique, the procedural risks are reduced by using fluoroscopic guidance (x-ray) for proper positioning and administration.


Cervical epidural steroid injections have proven to be highly effective in relieving neck pain. A 2007 study revealed a 72% effectiveness with the procedure (Kwon 2007).

The amount and duration of pain relief vary from person to person. Some find immediate relief from just one injection, but most require all three for maximum effectiveness.

If you are experiencing chronic neck pain that has lasted longer than four weeks or is severe you should contact Arkansas Pain Specialists about this highly effective treatment. Early intervention may decrease the chances of developing a worsening chronic pain syndrome.


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