Cervical Epidural Steroid Injection
A cervical epidural steroid injection (CESI) delivers powerful anti-inflammatory medication directly to the epidural space of the cervical (neck) spine, targeting the inflamed nerve roots responsible for neck pain, arm pain, numbness, and weakness. This is one of the most effective non-surgical treatments for cervical radiculopathy — the arm pain caused by a pinched nerve in the neck.
Conditions Treated
- Cervical disc herniation with arm pain (radiculopathy)
- Cervical spinal stenosis
- Cervical foraminal stenosis
- Degenerative disc disease of the cervical spine
- Neck pain with radiation to the shoulder, arm, or hand
The Procedure
Cervical epidurals are performed with exceptional care, as the anatomy of the neck requires precise needle placement. Dr. Rubin performs all cervical epidurals under fluoroscopic (live X-ray) guidance with contrast dye confirmation — the gold standard for accuracy and safety.
You lie face-down on the procedure table. Local anesthetic numbs the skin and deeper tissues. The needle is guided to the interlaminar space of the cervical epidural space under X-ray, and contrast is injected first to confirm position before the steroid is delivered. The procedure takes 20–30 minutes.
What to Expect
Most patients notice improvement within 1–2 weeks of the injection. Some experience immediate relief from the local anesthetic component, followed by a 24–48 hour period of soreness before the steroid effect builds over the following 1–2 weeks.
A series of up to three injections may be performed over a 6–12 month period. Many patients use cervical ESI as a bridge to allow physical therapy and recovery, potentially avoiding the need for cervical spine surgery.
Safety
Cervical epidural steroid injections require more technical precision than lumbar injections due to the anatomy of the neck. Dr. Rubin's extensive experience and the use of fluoroscopic guidance with contrast confirmation ensure the highest level of safety. Complications are uncommon but possible and will be reviewed at your consultation.
Frequently Asked Questions
Is this the same as a "neck injection"? Yes. Cervical epidural steroid injection, cervical ESI, and "neck injection" all refer to the same procedure when delivered to the cervical epidural space.
Will the injection eliminate my arm pain? Many patients experience significant reduction in arm pain after CESI. Complete elimination is possible for acute disc herniations, while degenerative conditions may see partial but meaningful improvement.
How is this different from cervical transforaminal injection? The interlaminar approach (CESI) delivers medication to a broad area of the epidural space. A transforaminal approach targets a specific nerve root foramen. Dr. Rubin will recommend the most appropriate approach based on your MRI findings and symptoms.
Request an Appointment
Call 516-492-3100 or use the form below to schedule a consultation for cervical pain and arm pain relief.