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Epidural steroid injections in the cervical spine — everything you need to know about these diagnostic and therapeutic injections

Epidural steroid injections can be used to diagnose and treat a variety of cervical spine conditions (those that occur in the neck). Such conditions include cervical spinal stenosis, herniated and bulging discs and pinched nerves. Because these conditions can cause similar symptoms, it’s important for a physician to determine the correct underlying cause as well as the most relevant corresponding treatment options.

Diagnostic injections

When used to diagnose neck pain, an epidural spinal injection is carefully delivered near the nerve that a physician believes might be pinched or inflamed. Advanced X-ray technology (fluoroscopy) is used to ensure that the correct nerve is targeted, and contrast dye is added to confirm the proper placement of the needle. This injection contains an anesthetic medication to numb pain temporarily. If the patient experiences a marked improvement in his or her pain immediately after an injection, the diagnosis is confirmed and the targeted nerve can then be treated. This diagnostic test is performed on an outpatient basis and patients can usually return home shortly after an injection.

Therapeutic injections

Once a patient is diagnosed, epidural steroid injections can be used to treat an affected nerve. The delivery process is the same and could occur at the same time as the diagnostic injection — medications are injected directly into the epidural space of the spine near the nerve that is being treated. These injections typically include the short-acting numbing agent (anesthetic) and a long-acting anti-inflammatory medication (corticosteroid).

When used to treat cervical spine pain, several epidural steroid injections can be given over the course of a year, although most physicians recommend a limit of three injections every 12 months. Injections can also be combined with other nonsurgical treatments, such as physical therapy, prescription and over-the-counter pain medications and activity modifications. However, if these conservative treatments do not produce the desired results, surgery might become an option.

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