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For certain types of neck or arm pain, your doctor may suggest a cervical epidural injection. During this procedure, medicine (such as numbing medicine or a steroid) is injected deep into your neck into your spinal canal or near the nerve root as it exits your spine. The injection helps the doctor find the source of your pain. It can also help ease your pain and soreness, either temporarily or more permanently. In rare cases, it can cause serious complications.

What are cervical vertebrae?

The cervical vertebrae are the bones that support your neck and head. They form the top part of your spine. The tunnel made by these vertebrae is called the spinal canal. The spinal cord runs through the spinal canal, inside a sac called the dura. Nerves branch off the spinal cord and exit between the vertebrae. Pressure on one of these nerves may cause it to become inflamed. An inflamed nerve in your neck may cause neck pain, numbness or weakness that may also be felt in your head or arms.

What is a cervical epidural injection?

In certain conditions, medicine can be injected into the epidural space. This space surrounds the dura within the spinal canal. Using an anesthetic to reduce discomfort from the procedure, a needle is inserted between the bones of the neck. When the correct location is reached, the medicine is injected. The injection is usually done with the help of imaging such as fluoroscopy. Care is taken to ensure a sterile procedure to reduce the chance of infection (which is rare, but can be very serious).

Possible risks and complications

  • Infection
  • Spinal headaches
  • Bleeding
  • Nerve damage
  • Spinal cord damage
  • Prolonged increase in pain

Serious complications of various types have been reported. Complications are much more frequent if you bleed easily or are taking a medication that thins your blood. Tell your doctor if you have a bleeding disorder or if you are taking a blood thinner.

Getting ready

  • Before treatment, tell your healthcare provider what medicines you take. This includes prescription and over-the-counter medicines. It includes aspirin and any vitamins, herbs and other supplements. Ask if you should stop taking any of them before treatment. If you are taking a blood thinner, please let the office know, as you will need to stop taking them for a period of time or a serious complication could occur.
  • Tell your provider if you're pregnant or could be pregnant.
  • Tell your provider if you're allergic to any medicines, especially iodine or iodine contrast.
  • Follow any directions you're given for not eating or drinking before the procedure.
  • If asked, bring X-rays, MRI scans or other tests with you to your treatment.

You may be given medicine to help you relax. You will lie on an X-ray table on your stomach. Stay as still as you can. During your treatment:

  • The skin over the injection site is cleaned. A medicine (local anesthetic) is used to numb the skin.
  • X-ray imaging (fluoroscopy) will be used to help your doctor see where the injection needs to go. A contrast material (also called “contrast dye”) may be injected into the region to help get a better image.
  • The cervical epidural injection is given. It may contain a local anesthetic to numb the region, medicines to ease inflammation (steroids) or both.
  • You can likely go home about 30 minutes after the procedure. It is helpful to have someone available to drive you home.
  • When the anesthetic wears off, your neck may feel more sore than usual. This is normal.
  • Rest and put ice or a cold pack on the area for 20 minutes. Do this a few times during the first day. To make an ice pack, put ice in a plastic bag that seals at the top. Wrap the bag in a thin towel or cloth. Don't put ice or an ice pack directly on the skin.
  • The steroids most often start to work in a few days.

Call your healthcare provider right away if you have:

  • Fever of 100.4°F or higher, or as advised by your healthcare provider
  • Nausea
  • Severe headaches
  • Arm weakness or numbness that gets worse
  • Trouble swallowing
  • Pain that gets much worse