Cervical Epidural Steroid Injection

What is a cervical epidural steroid injection?

Cervical epidural steroid injections (CESIs) are a frequently used treatment for neck and head chronic pain syndromes such as cervical radiculitis.

Cervical radiculitis results from nerve compression in the neck (cervical spine) that cause 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 spondylosis, which results from arthritis in the facet joints. Both causes can often be effectively treated with cervical epidural steroid injections.

Who is a good candidate for cervical epidural steroid injection?

This pain treatment is considered an appropriate non-surgical treatment for many patients who suffer from neck pain and headaches.


Chronic neck pain and cervical radiculitis are the most commonly treated condition with cervical epidural steroid injections. Headaches and cervical spinal stenosis may also benefit from this treatment modality.

How cervical epidural steroid injection works

Cervical epidural steroid injections 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 (to reduce inflammation and irritation) and a local anesthetic (to block pain), usually lidocaine and bupivacaine. The medicines spread to the most painful levels of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.

Are there risks?

Cervical epidural steroid injections do have risks, but they are typically low. 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 sugar, 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.

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