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Overview

The cervical spine contains nerve roots that supply the neck, shoulders and arms. When these nerves become inflamed—often due to disc irritation, arthritis, narrowing of the spinal canal or whiplash-related injury—they may trigger persistent pain, tingling, numbness or weakness.

A cervical epidural steroid injection places anti‑inflammatory medication into the epidural space around the affected nerves. This aims to calm irritation, reduce pain signals and support recovery. The procedure may be used for both diagnostic and therapeutic purposes.

Who this treatment helps

A cervical epidural steroid injection may be considered for people with:

  • Neck pain radiating into the shoulder or arm
  • Nerve-related symptoms such as tingling, burning or numbness
  • Pain aggravated by neck movement
  • Disc bulges or cervical radiculopathy
  • Whiplash-associated nerve irritation
  • Persistent symptoms despite physiotherapy or medication

A consultation is needed to confirm suitability and ensure the symptoms match a pattern that may respond to epidural treatment.

What is a Cervical Epidural Steroid Injection?

This procedure involves placing a fine needle into the epidural space of the cervical spine. A mixture of local anaesthetic and steroid medication is then delivered around the inflamed nerve roots. The steroid aims to reduce inflammation, while the local anaesthetic may provide temporary numbing to help confirm the source of pain.

Fluoroscopy (X‑ray guidance) or ultrasound may be used to optimise accuracy and safety. The injection is performed by a consultant pain specialist in a controlled clinical environment.

What to expect during the procedure

  1. Your consultant reviews the plan and answers any final questions.
  2. You lie comfortably on the procedure table.
  3. The skin of the neck is cleaned and numbed with local anaesthetic.
  4. Using imaging guidance, a fine needle is positioned in the epidural space.
  5. A small amount of contrast dye may be used to confirm placement.
  6. The steroid and local anaesthetic mixture is injected.
  7. You are monitored briefly before going home the same day.

The procedure typically takes 15–30 minutes.

After the procedure

  • Temporary numbness or heaviness in the arms may occur and usually settles within hours.
  • Some soreness at the injection site is normal.
  • Pain relief may begin within a few days, although steroid effects can take up to two weeks to develop.
  • Most people return to normal activities the next day, avoiding strenuous exercise for 24 hours.
  • Your consultant may recommend physiotherapy to support longer-term improvement.

Benefits

  • May reduce neck, shoulder or arm pain
  • Can help confirm whether nerve inflammation is the source of symptoms
  • May improve mobility and daily function
  • Minimally invasive with a short recovery period
  • Can support rehabilitation and exercise programmes
  • May reduce reliance on medication in some cases

Possible risks and side effects

Cervical epidural injections are generally safe when performed by experienced clinicians. Possible effects include:

  • Temporary increase in pain
  • Mild headache
  • Local bruising or soreness
  • Light-headedness
  • Rarely, infection or bleeding
  • Very rare nerve irritation

Your consultant will discuss individual risks and answer any concerns during your assessment.

When to consider other options

If symptoms do not improve, or if the pattern of pain suggests a different cause, your consultant may discuss:

  • Cervical facet joint injections
  • Nerve root blocks
  • Trigger point injections
  • Physiotherapy or posture-based rehabilitation
  • Medication review
  • Combined approaches for complex or persistent pain

Safety note

Please inform your consultant if you take blood thinners, have allergies, diabetes, active infection, are pregnant, or have had previous reactions to steroid or local anaesthetic. You may need someone to drive you home depending on the medications used.
Arrange a consultation to discuss whether cervical epidural steroids may be appropriate for you.

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