The Role of Cervical Epidural Steroid Injections in Non-Surgical Management of Spinal Stenosis

Spinal stenosis is a condition where the spaces within the spine narrow, putting pressure on the spinal cord and nerves. When spinal stenosis affects the cervical spine (the neck region), it can lead to pain, numbness, and weakness in the neck, shoulders, arms, and hands. While surgery may be necessary in some cases, many individuals find relief through non-surgical treatments. One of the most effective non-surgical options for managing cervical spinal stenosis is cervical epidural steroid injections.

What is Cervical Spinal Stenosis?

Cervical spinal stenosis occurs when the spinal canal in the neck narrows, leading to compression of the spinal cord or nerve roots. This condition can develop due to age-related degenerative changes, such as the thickening of ligaments or the formation of bone spurs. Other causes include herniated discs or tumors pressing on the spinal cord.

Common symptoms of cervical spinal stenosis include:

• Neck pain or stiffness
• Numbness or tingling in the arms or hands
• Weakness in the arms, shoulders, or hands
• Loss of coordination or balance
• In severe cases, difficulty walking

What Are Cervical Epidural Steroid Injections?

Cervical epidural steroid injections (CESIs) are a non-surgical treatment option that involves the injection of corticosteroid medication into the epidural space around the cervical spine. This space surrounds the spinal cord and nerve roots, and inflammation in this area can contribute to pain and discomfort.

The injection typically contains:

• A local anesthetic, which numbs the area temporarily to provide immediate relief.
• A corticosteroid, which helps reduce inflammation around the nerves and spinal cord, providing longer-lasting pain relief.

How Do Cervical Epidural Steroid Injections Help?

The primary goal of cervical epidural steroid injections is to reduce inflammation and provide pain relief for individuals suffering from cervical spinal stenosis. When the nerves in the neck are compressed, they become inflamed, leading to pain and other symptoms. By delivering corticosteroids directly to the affected area, the injection can significantly reduce inflammation and help alleviate pain, numbness, and weakness.

CESIs can also:

• Improve mobility and function, making it easier for patients to perform daily activities.
• Delay or even prevent the need for surgery by effectively managing symptoms.
• Serve as a diagnostic tool to pinpoint the specific source of pain.

When Are Cervical Epidural Steroid Injections Recommended?

Cervical epidural steroid injections are typically recommended for patients who have not responded well to other non-surgical treatments, such as physical therapy, medications, or lifestyle modifications. They are often considered for individuals with:

• Moderate to severe pain that affects daily activities.
• Persistent symptoms that don’t improve with oral pain medications or physical therapy.
• Radiating pain or nerve compression symptoms, such as numbness or tingling, that affect the arms and hands.

While these injections are not a cure for cervical spinal stenosis, they can provide significant relief, allowing patients to regain quality of life without immediate need for surgery.

What to Expect During the Procedure?

Cervical epidural steroid injections are performed on an outpatient basis and typically take around 20-30 minutes. The procedure is done under local anesthesia to numb the area, and some patients may also receive sedation for added comfort.

During the procedure:

1. The patient will lie on an examination table, and the skin over the neck will be cleaned and prepared.
2. A needle is inserted into the epidural space under fluoroscopic (X-ray) guidance to ensure precise placement.
3. The corticosteroid and anesthetic solution are injected into the affected area.

Most patients experience immediate relief from the local anesthetic, but the full benefits of the corticosteroid may take several days to manifest. The pain relief can last anywhere from a few weeks to several months, depending on the individual.

Risks and Considerations

Like any medical procedure, cervical epidural steroid injections come with some risks. These may include:

• Infection
• Bleeding
• Nerve damage (rare)
• Temporary increase in pain (due to irritation from the injection)

However, these risks are minimal, and the procedure is generally considered safe when performed by a trained specialist.

Contact the Experts at IGEA

At IGEA Brain, Spine, and Orthopedics, we provide expert care and individualized treatment options, helping patients manage their spinal conditions and avoid unnecessary surgeries.

If you're dealing with symptoms of cervical spinal stenosis, speak with our specialists to determine whether cervical epidural steroid injections could be an appropriate treatment option for you. Let us help you find relief and improve your quality of life.