A cervical epidural injection delivers steroids into the epidural space around spinal nerve roots to relieve pain in the neck region caused by irritated spinal nerves. It does so by reducing the inflammation of the nerves involved.
After the injection, the steroid medication is expected to start to help your pain in 1 to 5 days and can last for several days to a few months or longer. The injection may also have a local anesthetic agent to make the injection itself less painful. Nonetheless, the procedure leaves the neck or arm may be sore for a few days.
The standard recovery time is less than an hour. The blood pressure is being monitored for half an hour or so after the procedure. The patient will need someone to drive them home as they will not be able to do so themselves as they would have been sedated for the procedure and the residual effects are expected to be there.
During the recovery period, the patient is advised to perform less than the normal activity for a few days, following which daily routine can be resumed. They are advised not to take a bath for the first 24 hours. They do not have any dietary restrictions.
If they had been on any blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, prior to the procedure, they should consult their doctor prior to resuming them. There may be some tingling sensation in the arm, but it should only be transient. Ice packs should be applied to the injection site as it is expected to be sore for a few days post-procedure. It is advisable to see a physiotherapist in a week or 10 days after the procedure to ensure that the underlying cause of the pain is treated.
There are some side effects/complications of this procedure. These include a cortisone flare, which happens when the cortisone shot crystallizes in the inflamed area, creating pressure and worsening of pain. These are transient and treated with applying ice packs. In rare cases, there may be damaged to the cartilage or tendon during the procedure, which may cause a corrosive effect, softening cartilage and weakening tendons locally. There may be a spike in blood sugar as well, which is also temporary. Like any procedure, there is a small but real risk of infection. If pain begins to worsen or there is a swelling, bleeding from the site, or any unexpected neurologic problems, consult your doctor immediately.
People who have infections of the skin overlying the injection site, or who have a known history of allergic reaction to steroids should not get cortisone shots. It is important to provide a detailed history to your doctor to ensure that pain relief can be achieved in a safe and complication-free manner.