Cervical injections deliver medication directly into specific neck areas to alleviate pain from spinal structures. They are considered when conservative treatments, like physical therapy or oral medications, haven’t relieved persistent neck pain. The goal is to reduce inflammation or block pain signals, improving comfort and function.
Types of Cervical Injections
Cervical epidural steroid injections (CESI) target the epidural space around the spinal cord and nerve roots in the neck. They deliver corticosteroids, potent anti-inflammatory medications, to reduce swelling and irritation of compressed or inflamed spinal nerves. The medication spreads within the epidural space, reaching multiple nerve roots.
Cervical facet joint injections diagnose and treat pain from the small joints on each side of the neck’s vertebrae. These joints can become arthritic or inflamed, causing localized neck pain. The injection delivers anesthetic and often a corticosteroid directly into the joint capsule.
A cervical medial branch block is a diagnostic procedure to determine if facet joints are the source of a patient’s pain. This injection targets the medial branch nerves, which supply sensation to the facet joints. Numbing these nerves temporarily allows clinicians to assess if pain relief correlates with the facet joint as the pain source. If significant, but temporary, pain relief occurs, a longer-lasting treatment like radiofrequency ablation might be considered.
A cervical nerve root block focuses on a single nerve root suspected of inflammation or compression. It involves injecting a corticosteroid and local anesthetic precisely around the affected nerve root as it exits the spinal canal. This targeted delivery reduces inflammation and pain signals from that nerve.
Conditions Addressed by Cervical Injections
Cervical injections address conditions causing neck pain and radiating arm symptoms. They treat cervical radiculopathy, where a cervical nerve root becomes compressed or irritated, causing pain, numbness, or weakness in the arm or hand. This compression can stem from a herniated disc, where disc material presses on a nerve.
Spinal stenosis, a narrowing of the spinal canal or nerve root openings, is another condition treated. This narrowing can pressure the spinal cord or nerves, causing pain and neurological deficits. Degenerative disc disease, the breakdown of intervertebral discs, can result in disc space collapse and nerve impingement.
Facet joint arthritis, where cartilage in the facet joints wears down, is also addressed. This degeneration causes localized neck pain that often worsens with movement. Injections provide relief by reducing inflammation within these joints.
The Cervical Injection Procedure
Preparation for a cervical injection involves instructions from the healthcare provider, including fasting for several hours. Patients should also temporarily discontinue certain medications, especially blood thinners, to minimize bleeding risk. It is important to discuss all current medications and medical conditions with the physician beforehand.
During the procedure, the patient is positioned to allow optimal access to the neck, often lying on their stomach or side. The skin over the injection site is cleaned with an antiseptic solution to prevent infection. A local anesthetic is then injected into the skin and tissues to numb the area.
Imaging guidance, typically fluoroscopy (real-time X-ray) or sometimes ultrasound, ensures precise needle placement. The physician uses imaging to guide a thin needle to the target location, such as the epidural space, a facet joint, a medial branch nerve, or a specific nerve root. Contrast dye might be injected to confirm needle position and medication spread before administration.
Once placement is confirmed, the medication, usually a corticosteroid combined with a local anesthetic, is slowly injected. The entire procedure typically takes 15 to 30 minutes, varying by injection type and patient factors. Patients are monitored briefly after the injection before being discharged.
Post-Procedure Expectations and Considerations
After a cervical injection, patients are observed for 15 to 30 minutes for immediate reactions. Temporary numbness or weakness in the neck or arm, depending on the injection site, is common due to the local anesthetic. This sensation usually resolves within a few hours as the anesthetic wears off.
Pain relief from the corticosteroid is not immediate and can take several days, or up to a week, to become noticeable. The first few days after the procedure may see a temporary increase in pain or soreness at the injection site. This common, mild side effect can be managed with ice packs and over-the-counter pain relievers as advised by the physician.
Patients should avoid strenuous activities, heavy lifting, and excessive neck movements for 24 to 48 hours after the injection. Returning to normal activities is gradual, based on comfort and physician recommendations. While rare, potential side effects include infection, bleeding, or nerve damage, though sterile techniques and imaging guidance minimize these risks.
Contact a doctor if symptoms develop after the injection. These include persistent or worsening pain, fever, chills, significant redness or swelling at the injection site, or new or worsening neurological symptoms like severe weakness, numbness, or loss of bowel or bladder control. These signs indicate a complication that requires prompt medical attention.