Does the pain in your neck radiate down your shoulder or arm to your fingertips? Does your arm sometimes feel numb or weak? Symptoms like these are common to many people. Today, we're going to talk about a special injection that could be one solution to this.
Simply put, what is a cervical epidural steroid injection?
Don't be scared by the long name. Simply put, this is an injection of a medicine (a steroid) that reduces swelling into a small space called the 'epidural space' inside your neck, around your spinal cord.
The main purpose of this is to control chronic pain caused by a nerve root in your neck becoming compressed and swollen. This condition is medically known as 'Cervical Radiculopathy' . This is the pain that travels from your neck down your arm.
Let me explain a little. The word 'cervical' in the name comes from a Latin word meaning 'neck'. Therefore, this vaccine is injected into the neck, not the cervix of women. The similarity of the two words can cause a little confusion.
Okay, how does this injection reduce pain?
To understand this, let's first take a look at the structure of our neck.
Your cervical spine is made up of 7 small bones called vertebrae . Between these bones, like shock absorbers, are jelly-like discs called intervertebral discs . Together, these protect the spinal cord, which is like a supercomputer cable that runs down from your brain.
So, this is where the nerves that go to your arms, legs, and all over your body come out of this spinal cord. Sometimes, because of a herniated disk, or because of changes that happen as you age, this nerve root can become compressed. When a nerve is compressed, it swells and starts to hurt.
That's when this injection becomes important. The doctor injects this steroid directly into the swollen, irritated nerve.
- What does the steroid do? It directly reduces the swelling of that nerve.
- What happens when the swelling goes down? The pressure on the nerve is reduced.
- What happens when the pressure decreases? The pain and numbness you feel gradually decrease.
Simply put, this is about getting to the root of the problem, applying medication, reducing swelling, and giving the nerve a chance to heal. But remember, this is often only a temporary relief . For some people, it may not even relieve pain.
What types of neck problems is this vaccine used for?
This vaccine is mainly used for the condition I mentioned earlier called 'Cervical Radiculopathy'. That is, for symptoms caused by a pinched nerve in the neck. Those symptoms are:
- Pain that radiates down the neck, shoulder, and arm
- Numbness in the hands and fingers
- Weakness in the muscles of the hand (like having difficulty gripping something)
- A tingling sensation, like an electric shock
Below are some of the main medical conditions that can cause these symptoms.
| Disease status | Simply explained |
|---|---|
| Cervical Herniated Disk | A herniated disc is a herniated disc that ruptures, causing the jelly-like material inside to leak out and press on a nearby nerve. This is the main cause of neck pain. |
| Cervical Degenerative Disk Disease | As we age, the discs between the vertebrae wear down, which can cause nerve roots to swell. |
| Cervical Osteoarthritis/Spondylosis | As we age, changes occur in the bones, discs, and joints of the neck. This can reduce the space inside the spine and cause nerves to become compressed. |
| Cervical Spinal Stenosis | The spinal canal that runs through the neck narrows for various reasons. When space is reduced, there is more room for nerves to become compressed. |
What should you do before getting this vaccine?
After your doctor decides to give you this vaccine, he or she will give you some special instructions, which you must follow.
- If you are pregnant or planning to become pregnant, you should tell your doctor, as this procedure may require the use of an X-ray.
- Tell your doctor about all the medications you take (including vitamins and herbal remedies). It is especially important to tell your doctor about blood thinners . Your doctor may ask you to stop taking them for a few days.
- You may be asked to fast for a few hours before getting the vaccine.
- Often, an MRI or CT scan is ordered to see exactly where the problem is.
- You will be asked to bring someone to take you home on the day of the injection, as you may be given a light sedative.
What happens when the vaccine is given? Does it hurt?
This process usually takes between 15 and 30 minutes . It is very important that you remain as still as possible during this time.
How the process works:
1. Preparation: You will be changed into a hospital gown and laid on your stomach on a table.
2. Cleaning: The area of the neck where the vaccine is injected is thoroughly cleaned with an antiseptic solution. This reduces the risk of infection.
3. Numbing: Next, the doctor will inject a numbing medicine into the injection site using a small needle. This will help you not feel much pain when the larger needle is inserted.
4. Inserting the needle: Then, with the help of a special X-ray machine called fluoroscopy , the doctor guides the injection needle to the exact spot, close to the nerve.
5. Injection: Once the needle is in the correct place, the doctor will carefully inject the steroid. Sometimes, a numbing medicine may be mixed with the steroid.
6. End: After the injection is complete, a small plaster will be applied to the area where the needle was inserted, and you will be monitored for about 30 minutes before being sent home.
How is the pain?
The numbing medicine will feel like a small ant stinging you. You may feel pressure , a stinging sensation, a burning sensation , or a brief pain when the main injection is given. However, whatever you feel will go away once the injection is complete.
If you feel unbearable pain, you should tell your doctor right away.
What happens after you get vaccinated and go home?
After you go home, you may feel a little sore where the needle was inserted. This is normal. It will go away in a few hours. If you were given a numbing medicine, you may feel a slight heaviness or tingling in your neck, shoulder, or arm for a while. That will also go away after a while.
The doctor will tell you to rest for the rest of the day and not to exert yourself too much .
The most important thing is that your pain may increase slightly for the first two or three days after the injection. Don't worry about this. This is normal. The steroid medicine starts working in two to seven days . After that, the pain will start to subside.
What are the benefits and risks of this vaccine?
Like any medical treatment, this one has both benefits and risks.
| Advantages | Risks & Complications |
|---|---|
| It provides temporary relief from pain. | Low blood pressure, dizziness. |
| Because the pain is less, it becomes easier to do physiotherapy exercises. | Severe headache caused by spinal fluid leakage. |
| Daily tasks can be done easily. | Infection at the needle site (very rare). |
| Perhaps major treatment such as surgery may not be necessary. | Allergic reaction to medications. |
| Bleeding or nerve damage due to the needle accidentally entering a blood vessel (very rare). | |
| Frequent injections can weaken the bones or muscles of the spine. |
Most of these risks are very rare . Having this treatment performed by an experienced and skilled physician can further reduce this risk.
How long does the benefit from this vaccine last?
This varies from person to person. Some people experience pain relief for a few days to a few months . Some studies have shown that pain relief can last as long as 12-24 months. However, this rarely results in permanent relief .
Most doctors don't give more than two or three of these injections a year, because it's not good to inject steroids too often.
When do you need to see a doctor immediately?
If you experience any of the symptoms below after you get vaccinated and go home, call your doctor as soon as possible. Or go to the Emergency Department (ETU) of your nearest hospital.
- Severe headache: Especially if the headache worsens when standing or sitting and decreases when lying down.
- Fever: This could be a sign of an infection.
- If you feel persistent numbness or weakness in your hands.
Ultimately, this shot is just one treatment for neck pain. Using the temporary relief it provides, along with physical therapy exercises to strengthen the muscles around the neck is the best way to achieve long-term relief. If you have any questions about this, don't hesitate to ask your doctor.
Take-Home Message
- A 'Cervical Epidural Steroid Injection' is a special injection given to reduce swelling in a nerve, which is used to treat pain and numbness that radiates from the neck down to the arm.
- This often provides temporary relief, which can be used to move on to other treatments, such as physical therapy.
- It is essential to inform your doctor about all medications you are taking and if you are pregnant before treatment.
- The pain may be slightly increased for the first few days after the injection, but this is normal.
- If you experience a severe headache, fever, or prolonged weakness in your arm after the vaccination, seek medical advice immediately.
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