When to Get Neck Injections for Pain [and How to Prepare]
Have you been experiencing constant neck pain that radiates from your neck to your arm?
Do simple remedies like stretching, ice/heat therapy or pain medications give you zero relief?
Chronic neck pains are debilitating aches that can hamper your day-to-day activities.
Fortunately, a simple injection may be the answer you’ve been looking for.
What Injections Are Given For Neck Pain?
Neck injections for pain are administered to patients who have been dealing with long-term neck pain.
Cortisone injections for pain in the neck are one of the best alternative treatments before neck surgery is considered. If pain medications or physical therapy hasn’t worked to alleviate your neck pain, you might be the perfect candidate for one of these treatment options:
- Epidural steroid injection. A cervical epidural injection places steroids in the epidural space and into the dura (the membrane that covers your spine and nerve root in the neck). This will lower inflammation in the nerve roots, providing pain relief.
- Facet joint injections. This injection is recommended if the neck pains are caused by facet joint inflammation. The steroid is injected in the facet joint, a small joint behind your vertebral bones.
- Nerve root block. If the neck pains are associated with a damaged disk or a bone spur, the nerve root block is considered. This injection is inserted in the area around the spinal nerve root to decrease its inflammation.
What Is A Cervical Epidural Steroid Injection?
The cervical epidural injection is a minimally invasive procedure wherein both a corticosteroid and an anesthetic numbing agent are delivered to the epidural space (the area between the bone and the protective dura sac around the spinal nerves).
This type of corticosteroid injection has been proven as an effective treatment to decrease inflammation and pain in the neck area.
Although this injection is not intended to reduce the size of a cervical herniated disc, it can flush away some of the proteins that cause the swelling in the spinal cord and nerves.
This neck pain injection can bring long-term pain relief, allowing alternative treatments such as physical therapies and exercise programs to improve your spinal condition.
When Should You Get A Cervical Epidural Steroid Injection?
Patients who have been suffering from long-term neck and back pain are good candidates for an epidural steroid injection. It may benefit those particularly with the following conditions:
- Cervical radiculitis. Pain that radiates from the head or the neck down to the arm due to nerve compression in the cervical spine.
- Cervical Herniated Discs. Electric-like pain that’s felt from the neck down to the arms, which may be caused by trauma or neck injury.
- Cervical Spondylosis. Pain caused by the aging and normal wear-and-tear of the spinal disc in your neck.
Treatment through the cervical epidural steroid injection has been beneficial to patients with these painful neck inflammatory conditions.
In cases where rehabilitative exercises are required, these epidural injections work well in abating the pain to allow you to continue with physical therapy.
Furthermore, it can also help assess if more invasive treatments, such as surgery, are needed to address the pain.
Who Are Not Ideal Candidates For Cervical Epidural Steroid Injection?
A patient with the following conditions is at risk for complications:
- Patient with active infections, bleeding problems, high blood pressure, or diabetes
- If you are taking medications blood-thinners (eg. heparin, coumadin, etc.)
- If you are allergic to the epidural steroid medication (eg. corticosteroid, anesthetic)
You can discuss your conditions with our doctors and we will assess your pain management options.
How To Prepare For Cervical Epidural Steroid Injection?
If you are considering having cervical epidural steroid injections, preparation is key to lessen risks and complications.
Here’s how you can best prepare for your neck injection:
- Bring your complete medical data and history at your first appointment.
- Be sure to give your doctor a comprehensive list of all your medications so they know which medicines need to be discontinued or avoided before doing the procedure.
What To Expect Before The Procedure?
Before the treatment, your doctor will do a thorough medical examination.
Your medical history will be reviewed and several tests will be done to assess whether you are a good candidate for cervical ESI.
Once cleared, our doctors will list specific instructions on what you should do before the procedure.
For example, a typically required routine preparation is to not eat more than a small meal within a few hours before the injection.
Patients are also typically allowed to take their usual medications, except for those that have anti-inflammatory or blood-thinning effects.
What Happens During The Treatment?
What To Expect: Do Injections In Neck Hurt?
In general, injections can bring some mild discomfort, especially when the medications are delivered in small delicate areas.
Fortunately, local anesthetics (pain relief medication) will be administered before the injection so you can expect to only feel a small amount of pressure rather than pain when your doctor inserts the cervical corticosteroid injection.
If you’re concerned about pain from the neck injection, talk to your doctor to find out your options for pain relief medication.
You may request to be sedated during the procedure, but this is very uncommon as the procedure is not uncomfortable.
Remember to simply relax, stay calm, and take deep breaths during the procedure.
Step 1: Preparing For The Injection
Extensive assessments will be done by your doctor to figure out which site to inject. Ideally, they will target the medication as close to the painful nerve as possible.
To do this, x-ray fluoroscopy is used to take live imagery of your neck.
You will lie down on the x-ray table. A local anesthetic will be administered to numb the injection site and minimize pain.
Generally, patients are expected to be awake during the injection to be able to communicate any discomfort to the physician.
Step 2: Inserting The Needle
Through the x-ray fluoroscopy, the doctor will be able to see in real-time where to inject the epidural steroid.
A contrast dye will be used to ensure that the medication is flowing in the correct place.
The entry site will be on the side of the neck to access the neural foramen, which sits just above the opening of the nerve root and outside the epidural space.
The needle will go through the skin, between the bony vertebrae, and into the epidural space.
Step 3: Injecting The Corticosteroid
Once the local anesthetic takes effect and the needle is correctly positioned, your doctor will inject the epidural steroid injection into the epidural space that surrounds the inflamed nerve roots.
Depending on the pain location, one or several cervical spinal levels may need to be injected.
How To Recover After The Procedure?
After the injection, you will be monitored in a recovery area typically for up to an hour.
Many patients are already able to move and walk around post-injection.
However, for some, temporary weakness and numbness can occur in the legs, which will eventually wear off by the end of the day.
We advise the following to our patients:
- Be brought home by a companion
- Rest and avoid heavy activities for the rest of the day
- Avoid drinking or operating heavy machinery for at least the next 12 hours post-injection
Usually, many patients can resume their regular activities the following day.
However, you may expect soreness at the injection site. This can be alleviated by icing the area and taking mild analgesics that are recommended by your doctor.
What Results Can You Expect?
The medication may not go into full effect right away. It’s recommended to track the pain levels you feel within the next couple of weeks.
There may be days where the area feels much more painful, numb, or weak. This is normal as the numbing medications eventually wear off before the epidural steroid injections start to take effect within 2-7 days.
For those with mild neck pain, one or two injections may be administered within a 1 to 4-week interval to achieve the full relief.
How Long Do Neck Injections Last?
Depending on the severity of neck pain, patients who undergo cervical epidural steroid injections can expect pain relief that lasts for weeks up to years.
To achieve the best results, epidural injections are best done with physical therapy and neck exercise programs.
If you’ve been suffering from chronic neck pain, it may be best to consider cervical epidural steroid injections. Get in touch with us and we’ll schedule you for your first appointment!
Epidural steroid injections are a minimally invasive treatment wherein corticosteroids are injected in epidural space within the cervical area of your spine.
This results in decreased inflammation in the nerve and reduces neck pain.
These neck injections a safe, with very low risk associated with the procedure.
Not much preparation is needed, but it is important to discuss your medical history and list of medications to your doctor.
Full recovery can be experienced a day after the injection. The epidural steroid injections will take effect in about 2-7 days, but it can bring relief to long-term neck pain.
Cervical epidural steroid injections can be a life-changing experience, especially for those that have been dealing with chronic neck pains.
Have you had the procedure already? Share your experience with other people below!
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