Cervical Epidural Steroid Injection

Cervical/Thoracic Epidural Steroid Injection

(Fluoroscopic-Guided Injection to Reduce Neck and Arm Pain)

Overview

A cervical/thoracic epidural steroid injection is a common, minimally invasive procedure used to treat pain that originates from inflammation or compression of spinal nerves in the neck. This type of pain often radiates from the neck into the shoulder, arm, or hand and may be caused by disc herniation, spinal stenosis, or degenerative changes in the spine.

The injection delivers corticosteroid medication directly into the epidural space—the area surrounding the spinal cord and nerve roots—to reduce inflammation and nerve irritation.

This treatment is typically recommended when symptoms do not improve with conservative care such as physical therapy, medications, or activity modification.

Conditions treated with Cervical/Thoracic Epidural Steroid Injection include:

  • Cervical/thoracic radiculopathy (pinched nerve in the neck)
  • Cervical/thoracic disc herniation or bulge
  • Cervical/thoracic spinal stenosis
  • Degenerative disc disease
  • Nerve inflammation from auto accidents or workplace injuries
  • Whiplash-related disorders with nerve involvement

What are the risks and side effects?

Risks and side effects are minimal, and serious complications are rare. We take every precaution to ensure your safety. Potential risks may include but are not limited to:

  • Vasovagal response (fainting or dizziness)
  • New or increased pain
  • Infection
  • Bleeding
  • Permanent skin changes
  • Allergic or unexpected drug reaction with minor or major consequences
  • Unintended spinal or nerve injury

Ask your provider if you have any concerns. Your physician will review the risks in detail before the procedure to ensure you are fully informed.

Pre-Procedure Information

How Should I Prepare?

  • Driver Required: We ask that you arrange for a driver to take you home after the procedure.
  • Food: You may eat a light meal 1–2 hours prior to the procedure. If sedation is planned, please follow the specific sedation protocol provided by our team.

Medications:

  • Continue routine medications unless directed otherwise.
  • Blood thinners, Aspirin, NSAIDs, and supplements:
    • Inform us in advance if you take blood thinners (e.g., Plavix, Eliquis, Xarelto, Coumadin), NSAIDs (e.g., ibuprofen, naproxen), Aspirin, or supplements that increase bleeding risk.
    • Certain medications may need to be stopped for a short period of time before the injection.
    • Speak with your prescribing provider to ensure it’s safe to temporarily stop these medications.
    • Our team will review your medication list and coordinate with your other providers if needed.

    Notify us if:

    • You have a fever, infection, or recent illness.
    • You have started antibiotics or had changes to your medications.

Sedation

Most cervical epidural steroid injections can be performed comfortably without sedation. However, if you have anxiety or difficulty lying flat, mild sedation may be offered at the discretion of the physician. Please discuss this with your provider in advance.

Special Instructions for Diabetic Patients

Steroid injections may raise blood sugar levels for several days.

  • Please contact your primary care physician or endocrinologist prior to the procedure for management recommendations.
  • Monitor your glucose closely after the injection.
  • Report sustained elevations to your managing provider.

What if I am pregnant?

There are serious potential risks to an unborn fetus from imaging used during this procedure (e.g., X-ray/fluoroscopy). If there is any chance you may be pregnant, please notify our team immediately and postpone the injection until pregnancy is ruled out.

Procedure Information

The procedure is performed in a sterile outpatient setting under real-time X-ray (fluoroscopic) guidance.

What to Expect:

Preparation:

  • You will lie face down on a procedure table.
  • The skin will be cleaned and numbed with a local anesthetic.

Injection Process:

  • A needle is guided into the epidural space using fluoroscopy.
  • Contrast dye may be used to confirm positioning.
  • A corticosteroid is injected to reduce nerve inflammation.

Monitoring:

  • You will be monitored during the procedure to ensure comfort and safety.
  • Most procedures last 15–30 minutes, followed by a brief recovery period on-site.

Post-Procedure Information

What to Expect After the Procedure

  • Relief timeline: Steroids typically begin to work within 2 to 5 days, but in some cases may take up to 2 weeks.
  • Activity: Resume light activities the next day; avoid strenuous activity for 24 hours.
  • Soreness: Temporary soreness at the injection site is common.
  • Pain tracking: Keep a log of symptoms over the next 1–2 weeks.

Additional Instructions:

  • Contact the office for any signs of infection, fever, or worsening pain.
  • Attend follow-up as scheduled.

Schedule a Consultation

If you're experiencing pain due to a pinched nerve, disc issue, or spinal inflammation, a cervical/thoracic epidural steroid injection may provide lasting relief. Contact Restore Spine and Pain today to schedule your consultation and take the first step toward recovery.

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