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What are In-Office Cervical Injections?

In-office cervical injections are administered in a medical office or clinic setting to provide relief from pain or inflammation affecting the neck and upper back. The injection is made in the patient’s epidural space, which is the area between the outermost covering of the spinal cord, the dura mater, and the wall of the spinal canal.  It runs along the length of your spinal cord, is approximately 5 mm wide and is filled with spinal nerve roots, fat, and blood vessels. 

How Do In-Office Cervical Injections Work?

In-office cervical injections involve a mixture of an anesthetic and a steroid. By delivering an injection directly into the cervical epidural space, the medication moves freely, coating the inflamed or irritated nerve roots. The anesthetic functions by numbing the nerves to provide short or long-term pain relief, while the corticosteroids act as long-term anti-inflammatory agents, decreasing any swelling and irritation surrounding the nerves.

Indications for In-Office Cervical Injections

In-office cervical injections are usually employed when conservative measures, such as physical therapy or oral medications have failed to alleviate the symptoms of irritated cervical nerve roots. In-office cervical injections are indicated to treat conditions, such as:

  • Spinal stenosis
  • Bulging or herniated disc
  • Bone spurs
  • Cervical radiculitis
  • Cervical osteoarthritis
  • Failed cervical surgery (persistent pain despite surgery)
  • Other injuries to the spine

Pre-Procedure Preparation

Your doctor will review your medical history thoroughly before the procedure. You must inform your doctor about any health conditions you have such as diabetes or bleeding disorders, and about any medications you are taking, such as blood thinners, over-the-counter medications, or supplements. You may be asked to stop taking certain medicines for several days before the procedure. You will be instructed not to consume any food or drink for several hours prior to the procedure.

Procedure for In-Office Cervical Injections

In-office cervical injections are performed as an outpatient procedure in a clinic setting. You will lie face-down on the table. Your neck and upper back are sterilized with a cold antiseptic solution. The injection is performed using fluoroscopy (real-time x-ray imaging) or CT scans to assist the doctor in placing the needle accurately to target the pain so the patient can derive maximum benefit. An x-ray dye is used to ensure that the distribution of the injection is satisfactory. A small dressing is applied at the site of the injection to complete the procedure.

Postoperative Care

After the procedure, you will be taken to the recovery area where you will be required to stay for at least an hour. You will need to arrange for an escort to drive you home. If you have been sedated, you must not operate machinery, drive, or consume alcohol for 24 hours following the injection. You must follow all instructions on pain medications and attend follow-up appointments to monitor your progress.

Side Effects of In-Office Cervical Injections

Some of the possible side effects of in-office cervical injections include:

  • Pain at the injection site for a couple of days
  • Fluid retention for a couple of days due to the steroids
  • Headaches in some patients
  • Risk of infection
  • Facial flushing for a couple of days
  • Menstrual periods may be affected in females due to the effect of steroids
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  • The American Academy of Orthopaedic Surgeons
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