| r |
Cervical radiculitis results from nerve compression in the neck (cervical spine) that causes radiating pain down an arm.
The pain originates from cervical spinal nerves becoming irritated as they exit the spinal cord. The symptoms of cervical
radiculitis often include numbness and pain. If a person develops weakness in this distribution it is termed radiculopathy.
Cervical radiculitis can be caused by bulging cervical discs or cervical spondylysis, which results from arthritis in the facet
joints. Both causes can often be effectively treated with CESIs.
Procedure
CESIs involve injecting a steroid into the epidural space of the cervical spinal canal where irritated nerve roots are
located. The injected medications include both a long-lasting steroid and a local anesthetic (Lidocaine, Bupivacaine).
The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor
transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and
irritation. The entire procedure usually takes less than 15 minutes.
Benefits
Cervical steroid injections are considered simple and relatively painless. Approximately 72% of patients experienced
immediate pain relief in a 2007 research trial. The trial specifically evaluated the usefulness of a cervical interlaminar
epidural steroid injection in patients with neck pain and cervical radiculopathy (Kwon 2007). If pain relief is only
moderately achieved with the first injection, a series of injections is typically attempted.
The use of multiple injections was studied by the Department of Anesthesiology and Intensive Care at the University of
Pavia, Italy and they concluded that therapy with multiple injections provide better control of chronic cervicobrachial pain
compared to that with a single injection (Pasqualucci 2007). Therefore, three to six injections yearly may be
recommended by your pain specialist to maximize your pain relief.
The most important and greatest success achieved with the use of cervical steroid injections is the rapid relief of
symptoms that allows you to become active again. With this pain relief, you often regain the ability to resume normal daily
activities.
Risks
Cervical epidural steroid injections do have risks, but they are typically low. This pain treatment is considered an
appropriate non-surgical treatment for many patients who suffer from neck pain and headaches. Complications of the
injection can include bleeding, infection, headaches, and nerve damage. The medications used can also cause
pharmacological complications. These risks include allergic reaction, high blood sugars, decreased immune response,
and the potential for weight gain.
Along with proper technique, the procedural risks are reduced by using fluoroscopic guidance (x-ray) to position the
needle and watch the medication spread during the procedure.
Outcome
In a 2007 a research study was conducted, in patients with spinal stenosis (narrowing of the spinal canal) associated neck
pain. Cervical epidural steroid injections resulted in a 72% effectiveness in relieving neck pain. The study concluded that
the use of the injections is a “safe and effective” method in treating patients with cervical neck pain and cervical
radiculopathy (Kwon 2007).
The amount and duration of pain relief vary from person to person who receive cervical steroid injections. Some have
limited relief while others can benefit long-term. Many of the patients who receive these injections for management of
their chronic neck pain enjoy improved function and diminished pain and can benefit from additional procedures for
prolonged relief
If you are experiencing chronic neck pain that has lasted longer than four weeks or is severe you should contact Arizona
Pain Specialists about this highly effective treatment. Early intervention may decrease the chances of developing a
worsening chronic pain syndrome.
Articles
Epidural Local Anesthetic Plus Corticosteroid for the Treatment of Cervical Brachial Radicular Pain: Single Injection
Versus Continuous Infusion. Pasqualucci A, Varrassi G, Braschi A, Peduto VA, Brunelli A, Marinangeli F, Gori F, Colò F,
Paladini A, Mojoli F. PMID: 17710003
Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV,
Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB,
Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood
JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain
Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025
Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors.
Skeletal Radiol. 2007 May;36(5):431-6. Epub 2007 Mar 6
Kwon JW, Lee JW, Kim SH, Choi JY, Yeom JS, Kim HJ, Kwack KS, Moon SG, Jun WS, Kang HS
The pain originates from cervical spinal nerves becoming irritated as they exit the spinal cord. The symptoms of cervical
radiculitis often include numbness and pain. If a person develops weakness in this distribution it is termed radiculopathy.
Cervical radiculitis can be caused by bulging cervical discs or cervical spondylysis, which results from arthritis in the facet
joints. Both causes can often be effectively treated with CESIs.
Procedure
CESIs involve injecting a steroid into the epidural space of the cervical spinal canal where irritated nerve roots are
located. The injected medications include both a long-lasting steroid and a local anesthetic (Lidocaine, Bupivacaine).
The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor
transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and
irritation. The entire procedure usually takes less than 15 minutes.
Benefits
Cervical steroid injections are considered simple and relatively painless. Approximately 72% of patients experienced
immediate pain relief in a 2007 research trial. The trial specifically evaluated the usefulness of a cervical interlaminar
epidural steroid injection in patients with neck pain and cervical radiculopathy (Kwon 2007). If pain relief is only
moderately achieved with the first injection, a series of injections is typically attempted.
The use of multiple injections was studied by the Department of Anesthesiology and Intensive Care at the University of
Pavia, Italy and they concluded that therapy with multiple injections provide better control of chronic cervicobrachial pain
compared to that with a single injection (Pasqualucci 2007). Therefore, three to six injections yearly may be
recommended by your pain specialist to maximize your pain relief.
The most important and greatest success achieved with the use of cervical steroid injections is the rapid relief of
symptoms that allows you to become active again. With this pain relief, you often regain the ability to resume normal daily
activities.
Risks
Cervical epidural steroid injections do have risks, but they are typically low. This pain treatment is considered an
appropriate non-surgical treatment for many patients who suffer from neck pain and headaches. Complications of the
injection can include bleeding, infection, headaches, and nerve damage. The medications used can also cause
pharmacological complications. These risks include allergic reaction, high blood sugars, decreased immune response,
and the potential for weight gain.
Along with proper technique, the procedural risks are reduced by using fluoroscopic guidance (x-ray) to position the
needle and watch the medication spread during the procedure.
Outcome
In a 2007 a research study was conducted, in patients with spinal stenosis (narrowing of the spinal canal) associated neck
pain. Cervical epidural steroid injections resulted in a 72% effectiveness in relieving neck pain. The study concluded that
the use of the injections is a “safe and effective” method in treating patients with cervical neck pain and cervical
radiculopathy (Kwon 2007).
The amount and duration of pain relief vary from person to person who receive cervical steroid injections. Some have
limited relief while others can benefit long-term. Many of the patients who receive these injections for management of
their chronic neck pain enjoy improved function and diminished pain and can benefit from additional procedures for
prolonged relief
If you are experiencing chronic neck pain that has lasted longer than four weeks or is severe you should contact Arizona
Pain Specialists about this highly effective treatment. Early intervention may decrease the chances of developing a
worsening chronic pain syndrome.
Articles
Epidural Local Anesthetic Plus Corticosteroid for the Treatment of Cervical Brachial Radicular Pain: Single Injection
Versus Continuous Infusion. Pasqualucci A, Varrassi G, Braschi A, Peduto VA, Brunelli A, Marinangeli F, Gori F, Colò F,
Paladini A, Mojoli F. PMID: 17710003
Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV,
Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB,
Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood
JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain
Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025
Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors.
Skeletal Radiol. 2007 May;36(5):431-6. Epub 2007 Mar 6
Kwon JW, Lee JW, Kim SH, Choi JY, Yeom JS, Kim HJ, Kwack KS, Moon SG, Jun WS, Kang HS
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Arizona Pain Specialists can
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Cervical Epidural Steroid Injections
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
Cervical epidural steroid injections (CESIs) are a frequently used
treatment for neck and head chronic pain syndromes. Chronic
neck pain and cervical radiculitis are the most commonly treated
condition with CESIs. Headaches and cervical spinal stenosis
may also benefit from this treatment modality.
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
Cervical epidural steroid injections (CESIs) are a frequently used
treatment for neck and head chronic pain syndromes. Chronic
neck pain and cervical radiculitis are the most commonly treated
condition with CESIs. Headaches and cervical spinal stenosis
may also benefit from this treatment modality.
Book I - Pain Syndromes
Chapter 1 Low Back Pain
Chapter 2 Neck Pain
Chapter 3 Cancer Pain
Chapter 4 Headaches
Chapter 5 Spinal Stenosis
Chapter 6 Sciatica
Chapter 7 Arthritis
Chapter 8 Fibromyalgia
Chapter 9 Motor Vehicle Injuries
Chapter 10 Complex Regional Pain
Syndrome
Chapter 11 Vertebral Body
Fractures
Chapter 12 Hip and Leg Pain
Chapter 13 Diabetic Peripheral
Neuropathy
Book II - Interventional Procedures
Chapter 14 Epidural Steroid
Injection
Chapter 15 Facet Injections/Medial
Branch Blocks
Chapter 16 Radiofrequency Ablation
Chapter 17 Spinal Cord Stimulator
Implants
Chapter 18 IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20 Discography
Chapter 21 Percutaneous
Discectomy
Chapter 22 Occipital Nerve Block
Chapter 23 Sympathetic Block
Chapter 24 Stellate Ganglion Block
Chapter 25 Intrathecal Pump
Implants
Chapter 26 Caudal Steroid Injection
Chapter 27 Adhesiolysis
Chapter 28 Cervical Steroid
Injection
Chapter 29 Sacroiliac Joint
Injections
Chapter 30 Celiac Plexus Block
Chapter 31 Head and Neck
Procedures
Chapter 32 Joint Injections
Chapter 33 Continuous Catheter
Nerve Blocks
Chapter 34 Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35 Disc Denervation
Book III Other Treatments
Chapter 36 Medication Management
Chapter 37 Acupuncture
Chapter 38 Prolotherapy
Chapter 39 Botox
Chapter 40 Massage
Chapter 41 Alternative and
Complementary Medicines
Chapter 42 Exercise and Nutrition
Counseling
Chapter 43 Prayer
Chapter 44 Cognitive Behavioral
Therapy
Chapter 45 Group Therapy
Chapter 46 Biofeedback
Chapter 47 Chiropractic
Manipulations
Chapter 48 Vitamin Supplements
Chapter 49 Customized
Pharmaceutical Formulations
Chapter 50 Hormone Therapy
Frequently Asked Questions
Chapter 1 Low Back Pain
Chapter 2 Neck Pain
Chapter 3 Cancer Pain
Chapter 4 Headaches
Chapter 5 Spinal Stenosis
Chapter 6 Sciatica
Chapter 7 Arthritis
Chapter 8 Fibromyalgia
Chapter 9 Motor Vehicle Injuries
Chapter 10 Complex Regional Pain
Syndrome
Chapter 11 Vertebral Body
Fractures
Chapter 12 Hip and Leg Pain
Chapter 13 Diabetic Peripheral
Neuropathy
Book II - Interventional Procedures
Chapter 14 Epidural Steroid
Injection
Chapter 15 Facet Injections/Medial
Branch Blocks
Chapter 16 Radiofrequency Ablation
Chapter 17 Spinal Cord Stimulator
Implants
Chapter 18 IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20 Discography
Chapter 21 Percutaneous
Discectomy
Chapter 22 Occipital Nerve Block
Chapter 23 Sympathetic Block
Chapter 24 Stellate Ganglion Block
Chapter 25 Intrathecal Pump
Implants
Chapter 26 Caudal Steroid Injection
Chapter 27 Adhesiolysis
Chapter 28 Cervical Steroid
Injection
Chapter 29 Sacroiliac Joint
Injections
Chapter 30 Celiac Plexus Block
Chapter 31 Head and Neck
Procedures
Chapter 32 Joint Injections
Chapter 33 Continuous Catheter
Nerve Blocks
Chapter 34 Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35 Disc Denervation
Book III Other Treatments
Chapter 36 Medication Management
Chapter 37 Acupuncture
Chapter 38 Prolotherapy
Chapter 39 Botox
Chapter 40 Massage
Chapter 41 Alternative and
Complementary Medicines
Chapter 42 Exercise and Nutrition
Counseling
Chapter 43 Prayer
Chapter 44 Cognitive Behavioral
Therapy
Chapter 45 Group Therapy
Chapter 46 Biofeedback
Chapter 47 Chiropractic
Manipulations
Chapter 48 Vitamin Supplements
Chapter 49 Customized
Pharmaceutical Formulations
Chapter 50 Hormone Therapy
Frequently Asked Questions