Cervical Interlaminar Epidural Steroid Injections

A cervical interlaminar epidural steroid injection is an outpatient procedure for treating neck, upper back, shoulder, and arm pain. This information sheet will explain what it is. Your doctor can explain if it is for you.

What is the epidural space?

The dura is a protective covering of the spinal cord and its nerves. The space surrounding the dura is called the epidural space. In the neck, it is called the cervical epidural space.

What causes pain in the epidural space?

The cervical area of the spine has seven bones, called vertebrae. Soft discs found between these vertebrae cushion them, hold them together, and control motion. If a disc tears, chemicals inside may leak out. This can inflame nerve roots or the dura, and cause pain. A large disc tear may cause a disc to bulge, inflaming nerve roots or the dura, and cause pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.

How do I know if I have disc and nerve root pain?

If you have pain in your neck or upper back when you move your head or neck, you may have cervical disc or dural inflammation. if pain travels to your arm when you move your head or neck, you may have nerve root inflammation. Common tests such as MRIs can show disc bulges and nerve root compression, but may not show a torn and leaking disc. A cervical epidural injection may provide relief if disc problems, or dural, or nerve root inflammation are causing your pain.

What is a cervical interlaminar epidural steroid injection?

In a cervical epidural steroid injection, a corticosteroid (anti-inflammatory medicine) is injected into the epidural space to reduce inflammation. A local anesthetic (numbing medicine) may also be injected. The simplest way is from the back of the spine. This is called an interlaminar injection.

What happens during/after an injection?

A local anesthetic will be used to numb your skin. The doctor will then insert a thin needle directly into the facet joint. Fluoroscopy, a type of x-ray, must be used to ensure the safe and proper position of the needle. A dye may also be used to make sure the needle is in the correct spot. Once the doctor is sure the needle is correctly placed, the medicine is injected. You will be monitored for up to 30 minutes after the injection. When you are ready to leave, the staff will give you discharge instructions. You will also be given a pain diary. It is important to fill this out because it helps your doctor know how the injection is working. It may help to move your back in ways that hurt before the injection, to see if the pain is still there, but do not overdo it. Take it easy for the rest of the day. You may feel immediate pain relief and numbness in your back for a period of time after the injection. This tells you the medication has reached the right spot. Your pain may return after this short pain-free period or may even be a little worse for a day or two. It may be caused by needle irritation or by the corticosteroid itself. Corticosteroids usually take two or three days to start working but can take as long as a week. You can usually return to work the day after the injection, but always check with your doctor.


How long can I expect pain relief?

The extent and duration of pain relief may depend on the amount of inflammation and how many areas are involved. Other coexisting factors may be responsible for your pain. Sometimes an injection can bring several weeks to months of pain relief, and then more treatment is needed. Other times, particularly if there is no underlying bone or joint problem, one injection brings long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by one injection. This pamphlet is for general education only. Specific questions or concerns should always be directed to your doctor. Your doctor can explain possible risks or side effects

To schedule an appointment with one of our pain management specialists, call us today!



January 30, 2019 Neck0

Life can be a pain in the neck. That may be an old phrase, but there’s a lot of truth to it.

Neck pain happens to many people and for many different reasons. It’s annoying  and makes life a lot more difficult. The phrase “pain in the neck” dates back to around the turn of the century, so people have had this issue for quite a while. 

Unfortunately, getting rid of neck pain often means knowing why you have it. That’s why we’ve compiled a list of ten of the most common causes of neck pain. Read on, and we’ll try our best to eplain everything.

1. Posture or Sleeping Position

How we stand, sit, and sleep can affect a lot of things, and neck pain is one of them. In particular, craning your neck forward, such as when texting, surfing the internet or even reading a book, is a bad idea.

Keep in mind, we’re not telling you to stop doing these things, or even to cut back,but be aware of neck craning and try to avoid it in the future.

When it comes to sleeping, there could be a few different solutions. One such solution is to sleep on your back. Sleeping on your side can compress your spine and cause those annoying neck pains. 

You may also be using too many  or too few pillows, which can cause your neck to rest at an unnatural angle. You may want to consider investing in a memory foam pillow, which will support your neck without forcing it into an odd position.

2. Stress

It seems like every day, we find out that stress does something else to us. In this case, it can cause our muscles to grow taut, which makes it easier to strain them. If you’re the type who feels stressed and overwhelmed on a regular basis, your risk for stress-related injuries goes up.

The best advice for this is to calm down. Take a break whenever you feel the need to.

If frequent stress is a problem for you, one that’s disrupting your life significantly, we encourage you to see a counselor. They can teach you to help manage your symptoms and even refer you to a psychiatrist if they believe medication might help.

3. Carrying Too Much Weight

Don’t worry, this isn’t an entry about losing weight, although that can still be a health issue. It’s about literally carrying weight, like in the form of a purse or a backpack.

Carrying too much weight, and especially carrying it unevenly, causes our spines to bend and strain, which can lead to injury and discomfort. In terms of how to cure it, the only thing we can suggest is trying to distribute weight evenly, and cut down on it if you can.

4. Brachial Plexus Injury

The brachial plexus is a set of nerves that start in the neck and stretch down into the arms and hands. There are many potential causes of a brachial plexus injury, but the most common ones are motor vehicle accidents and sports injuries.

Having a brachial plexus injury is a bit like having a broken arm. It hurts or feels numb, and you may not be able to move it. In most cases, these injuries will heal naturally in a few months or less.

If they don’t, you should seek medical attention, because your condition may require surgery.

5. Whiplash

Whiplash has some of the same causes as a Brachial Plexus injury, and a few of the symptoms may be similar. However, a person with whiplash may also suffer from headaches, pain in the lower back, dizziness, tinnitus, and other symptoms besides.

Treatments for whiplash are often simplistic. They include pain pills, ice packs, physical therapy and home-based or outpatient procedures. Symptoms will often disappear within a month.

6. Pinched Nerve

In the neck, a pinched nerve will feel a lot like a brachial plexus injury and can be caused by many of the same things. However, a pinched nerve can also be the result of being overweight.

The big difference is that a pinched nerve usually disappears within several days. They also can be alleviated, to an extent, by home remedies such as ice packs.

7. Slipped Disk

Often caused by age, this condition occurs when one of the cushioned discs between vertebrae becomes prolapsed. This means that the bones in your spine are not as well protected, which results in pain during daily activities, often on one side of the body. You may also suffer tingling and muscle weakness.

Though age is one of the causes, it isn’t the only possible cause. You can also suffer a slipped disc from excessive muscle strain or being overweight.

Slipped discs need to be diagnosed by a doctor. This will often require a discogram, but can usually be treated non-surgically using painkillers and regular mild exercise. 

8. Headaches

Certain types of headaches can have neck pain and stiffness as a symptom, including migraines. If this is the case, it should go away when the headache does.

Most headaches, even migraines, can be treated with home care and painkillers. If you suffer from migraines, you should also consider therapy for help in reducing stress.

9. Age

Aging makes us more susceptible to neck pain and medical conditions that can cause them. One such condition is arthritis.

In most cases, nothing can cure these conditions, but consulting with a doctor may help you find ways to cope with them or even slow their progression.

10. Sprains, Strains and the Unexplained

Like it or not, there’s not always an obvious explanation for pain. It may be something as simple as a sprain or strain, or some other mild, short-lived ache.

Our bodies are weird, and they sometimes do things we can’t explain. Unless sprains and strains are happening a lot, there’s no need to see a doctor.

Causes of Neck Pain

There are many potential causes of neck pain. Some come from sports injuries, being overweight, or car accidents. In some cases, you could just have poor posture or be too stressed out. It may even be the result of age or some random pain that comes and goes with no explanation.

That’s only a few explanations. If you want to know more, we encourage you to do research on your own.

The best advice we can give is to try to stay healthy and active, and to see a doctor if something feels wrong. 

If you want to know more about pain and how to treat it, please visit our site. We can tell you all about the different kinds of stem cells and what role they play in medicine.

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