Introduction
Cervical transforaminal epidural steroid injections are a non-surgical treatment option designed to alleviate pain in the neck, shoulders, and upper extremities. The cervical spine is particularly vulnerable to injury and degeneration, which can result in pinched nerves that cause pain in the neck and radiating down into the shoulders and arms. These injections deliver medication directly to the source of the pain and serve as both a diagnostic tool and a therapeutic option.
Anatomy
The cervical spine, located in the neck, consists of seven small vertebrae. Between each vertebra is a disc that allows for movement, provides stability, and absorbs shock. These vertebrae form the spinal canal, which protects the spinal cord—a major component of the nervous system extending from the brain.
The spinal cord does not fill the entire spinal canal but is surrounded by the epidural space, which contains nerves, tissues, and blood vessels. Cervical nerves exit the spinal cord through small openings in the vertebrae called foramina. These nerves control functions such as sensation and movement in areas like the head, neck, shoulders, arms, wrists, and hands.
Causes
Cervical transforaminal epidural steroid injections are used to relieve pain caused by pinched nerves in the neck. Conditions like herniated discs, radiculopathy (spinal nerve root disease), and spinal stenosis—which narrows the spinal canal and compresses the nerves—can all lead to nerve irritation and pain.
Symptoms
The symptoms of cervical nerve compression vary depending on the cause but may include neck pain, numbness, and tingling that radiates into the shoulders, arms, and hands. Symptoms can worsen with neck movement, coughing, or laughing. Muscle spasms in the neck and weakness in the arms or hands may also occur.
Diagnosis
To determine the underlying cause of your neck pain, your doctor will perform a physical examination and may use imaging tests, lab work, or nerve studies. Based on these results, your doctor will decide if cervical transforaminal epidural injections are appropriate for you.
Treatment
Cervical transforaminal epidural injections deliver anesthetics and/or corticosteroids directly into the foramen, the passageway through which spinal nerves exit the spine. This medication reduces inflammation and helps relieve pain by targeting the irritated nerve.
The procedure is a brief, outpatient treatment that can be performed in a surgery center, hospital, or clinic. You will wear a gown, and depending on the doctor's instructions, be positioned sitting up or lying down. Before the injection, the area at the back of your neck will be cleaned and numbed with a local anesthetic. You may also receive a sedative to help you relax.
Your doctor will use live X-ray guidance (fluoroscopy) to ensure the needle is precisely placed into the foramen. Contrast dye may be injected to confirm correct needle placement, followed by the injection of the medication. After the procedure, you will be monitored for a short period before being discharged.
Some patients experience significant pain relief after a single injection, while others may require additional treatments for optimal results.
