Cervical Spine Epidural

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This procedure is performed to treat chronic pain of the neck, shoulders and arms. By injecting steroid medication into the epidural space at the top of the spine, inflammation can be decreased, eliminating or lessening pain and aiding in the healing process.

Need to Know

Nice to Know
  • You should not eat or drink anything for at least eight hours before the procedure
  • If you take blood thinners, such as Coumadin, or other medications, your doctor may instruct you to stop taking your medication for a period of time before the procedure.
  • Inform your physician if you are pregnant.
  • You will be awake during the procedure and can go home afterward
  • You will be given a gown to wear during the procedure
  • You will probably be asked to use the bathroom before the procedure

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How Does It Work?

Using image-guidance from either fluoroscopy (X-rays that show motion inside your body in real-time) or CT scans, your doctor will place a long needle into the top of your spine and inject steroid medication to help reduce swelling and alleviate pain.

What Happens — Before, During, and After?

When you arrive for your procedure a nurse will greet you and let the team know you’ve arrived. You will be brought into an exam room and asked to change into a gown. Your doctor will greet you, explain the procedure and answer any questions you may have.

You will likely lie on your side on the exam table for this procedure. In some cases patients receive an IV line but this most-likely will not be necessary. Your doctor will clean the area with an antiseptic solution and cover it with a surgical drape. Your doctor will then give you a shot of local anesthesia to numb the area. You will feel a small pinch as the anesthesia is administered.

Once the area is numb, your doctor will use either fluoroscopic imaging -- which uses X-rays to guide the epidural – or CT scans, to administer the epidural injection. Your doctor will slowly guide the epidural needle into the space in your spine that corresponds to your pain. Once the epidural needle is in place, your doctor will inject the medication. You will not feel pain as the needle is placed but you may feel some discomfort as the medicine enters your spine. This should only last a short moment and will most likely dissipate as soon as the injection is complete. Once the medicine has been administered you may feel some tingling. You should tell your doctor if you feel any sharp pain.

In most cases this procedure takes only a few minutes. Once the procedure is complete, the epidural needle will be removed and you will likely have a small bandage over the wound. You may need to stay in the doctor’s office for a short while (perhaps an hour) until you feel ready to go home.

You may feel some difficulty walking or standing up/sitting down immediately after the procedure. This should subside within a few hours. Your doctor will likely tell you to rest for the remainder of the day but you may resume your normal activities the following day.

The epidural may not have immediate pain-relieving effects but you will likely feel lessening pain over the next two days. This pain relief can last anywhere from a few days up to a few months and in some cases longer, depending on your case.

Your doctor will discuss any need for a follow-up visit before you leave.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone drop you off and pick you up. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Some other things to keep in mind in planning for this procedure include:

  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.
  • The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a nurse from your doctor’s office will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
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What Should I Bring?

On the day of your procedure you should:

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable, shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of an epidural steroid injection could be:

  • Relief of neck, shoulder or arm pain
  • Reduced inflammation which may lead to healing

Some risks you should be aware of include:

  • As with any procedure there is a slight risk of infection
  • Rarely, this procedure can cause a temporary increase in pain
  • Epidural injections may cause severe headaches. This is rare.
  • Rarely there are reactions to the pain medication such as rash or hot flashes
  • There is a slight risk of nerve damage at the injection site
  • There is a slight risk of bleeding
  • If fluoroscopy is used, there are risks associated with exposure to X-rays. You should discuss this with your physician.

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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