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!



What is failed back surgery syndrome?

This is when patients fail to improve or worsen after spine surgery. Patients will continue to take large amounts of pain medication and are unable to return to normal activities. It is not one specific problem, but rather a term for people who back surgery didn’t help.

What causes failed back surgery syndrome?

There are many causes for failed back syndrome including unrealistic expectations (they wanted to feel like they were twenty), incorrect diagnosis and treatment, correct diagnosis but wrong surgery or the problem was not properly fixed.

What are symptoms of failed back surgery syndrome?

A new problem may form after surgery such as disk herniation, blood clot, infection or scar tissue. Muscle damage or bone removal may lead to spinal weakness, instability and new severe pain.

How do we treat failed back surgery syndrome?

Depending on the symptoms, there are a couple of routes our doctors can take. We could treat the symptoms with medication, injections, or a minimally invasive procedure. These procedures include spinal cord stimulators and radiofrequency ablations.

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



October 13, 2022 Health and Wellness0

Thomas Lembo was a Vietnam veteran and a retired police officer who served 30 years on the force in Elizabeth, NJ. Thomas described the horrors he dealt with during his career. “I have seen and been through things in my life that people only see in war movies. I have had several violent and disturbing encounters including a chemical explosion, being shot at, stabbed, and run over. I have been through things that no one should ever have to go through or see in their lifetime.”

These life events led Thomas to suffer from PTSD. He explained, “Up until 3 years ago I became more aware of my mortality. I felt like my armor fell off that I had on all these years. Everything started going bad in my life. I had nightmares daily. I couldn’t sleep. I was depressed and always on edge. All the years of trauma caught up with me and I was suffering.” Thomas knew he had to figure out something to help him deal with his PTSD. He and his wife found out about stellate ganglion injections, and he quickly asked his primary doctor about them. His doctor recommended Dr. Mann and after a thorough description of the procedure, Thomas decided to proceed. After a quick recovery, Thomas had this to say about the stellate ganglion injections.

“Within 3 days I felt instant relief. I was much more relaxed. I don’t have nightmares anymore. I feel like there is a weight lifted off of me that had been pulling me down.” “This has changed my life. I was at a loss, and because of receiving the injection I have my life back. It has been a revelation.”


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