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Desert Pain Specialists

Cervical epidural steroid injections (CESIs)

Cervical epidural steroid injections (CESIs) are a frequently used treatment for neck and head chronic pain syndromes. Chronic neck pain and cervical radiculitis are the most commonly treated condition with CESIs. Headaches and cervical spinal stenosis may also benefit from this treatment modality.

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

CESIs 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 and a local anesthetic (Lidocaine, Bupivacaine).
The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor
transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and
irritation. The entire procedure usually takes less than 15 minutes.

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