In brief
- The injection reduces swelling around the irritated nerve root, putting out the fire of inflammation.
- Hold NSAIDs and aspirin for 24 hours; blood thinners have longer holds.
- Expect a possible increase in soreness or a fullness sensation in the neck for 2 to 5 days.
- Full relief usually develops over 3 to 7 days, and peak relief can continue to build for several weeks.
Understanding your diagnosis
Cervical radiculopathy, or a pinched nerve, occurs when a nerve root in your neck is irritated. This can be caused by a disc herniation, spinal stenosis, or bone spurs. This inflammation is what leads to the pain, numbness, or electric sensations you feel traveling down into your arm or hand.
The treatment
A cervical epidural steroid injection is a minimally invasive treatment in which anti-inflammatory medication (steroid) is placed into the epidural space. This medication works to reduce swelling around the nerve, putting out the fire of inflammation to relieve pain and help you return to your normal activities.
Our approach
Dr. Pugh performs these injections using the C7–T1 interlaminar approach. This level, where the base of the neck meets the upper back, offers the safest and most effective anatomical entry point. From here, the medication can flow upward to target the specific irritated nerves in your cervical spine.
Before your procedure
For your safety, certain medications must be held before your procedure to minimize the risk of bleeding, following American Society of Regional Anesthesia guidelines. This procedure requires the 24-hour NSAID hold.
| Medication type | Examples | Required hold |
|---|---|---|
| NSAIDs | Ibuprofen, Motrin, Aleve, naproxen, meloxicam | 24 hours |
| Salicylates | Aspirin, all doses | 24 hours |
| Antiplatelets | Plavix (clopidogrel), Brilinta | 7 days |
| Antiplatelets | Effient (prasugrel) | 10 days |
| Anticoagulants | Eliquis, Xarelto, Savaysa, Pradaxa | 5 days |
| Vitamin K antagonist | Coumadin, warfarin | 5 days (INR below 1.5) |
Restarting
Most medications can be restarted 24 hours after the procedure. NSAIDs and aspirin may be resumed immediately.
Fasting, sedation, and your ride home
- If you are receiving sedation, nothing to eat or drink for six hours before your appointment. Essential morning medications may be taken with a small sip of water only.
- We offer light or deep sedation. The level is decided by the physician and anesthesia team based on the procedure and clinical need.
- Any patient receiving sedation must be accompanied by a responsible adult driver to take them home.
Where to go
Procedures are performed at one of three facilities: our clinic at 1925 Hospital Place, ACOM at 6449 Central Park Blvd, or Hendrick South at 6399 Directors Pkwy, Suite 100. Your appointment paperwork tells you which one. Please arrive early for registration and pre-procedure preparation.
Procedure day
- Performed under live X-ray (fluoroscopy) for maximum precision.
- We use local numbing medication to ensure a comfortable experience.
- The entire procedure typically lasts about 15 minutes.
- You will be able to walk out and go home shortly after the injection.
Benefits
- Significant reduction in radiating arm pain.
- Reduced need for oral pain medications.
- Improved ability to perform physical therapy.
Recovery
- Return to regular activity the same day.
- Full relief usually develops over 3 to 7 days.
- A brief follow-up will be scheduled to assess your relief and function.
Afterward: what to expect
- The flare. Expect a potential increase in localized soreness or a fullness sensation in the neck for 2 to 5 days. Use ice packs (20 minutes on, 20 off) and continue baseline medications.
- Results. Peak relief typically occurs between 6 weeks and 3 months.
- Blood glucose. Expect a temporary rise in blood glucose levels, which usually resolves within a few days. Diabetic patients should monitor their sugar levels closely for 48 to 72 hours after the procedure.
Activity
Wound care
Your procedure in one paragraph
You have undergone a cervical epidural steroid injection, a specialized procedure designed to treat chronic neck, shoulder, or arm pain originating from the cervical spine. Using real-time imaging, we have delivered a concentrated blend of anti-inflammatory medication (steroid) and local anesthetic into the epidural space, the area surrounding the spinal nerves. This procedure was performed to reduce nerve root inflammation and dull the pain signals traveling from your neck to your extremities.
Follow-up schedule
- 1
1 month
Formal functional assessment of how well the injection worked.
Call us right away if you notice
- New or worsening leg weakness, numbness, or foot drop
- Sudden loss of bowel or bladder control
- Fever above 101.5°F, chills, or drainage at the site
- A severe headache that worsens when sitting or standing
This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.