The cervical (neck) intervertebral discs are an integral part of your dynamic spine. Discs work in conjunction with the vertebral bodies to absorb and distribute stress and weight changes the neck incurs during inactivity and movement.
Discs are composed of an outer layer or annular fibrosis; a tough substance that retains the inner disc cushioning material, the nucleus pulposus. The nucleus is avascular and does not contain nerves. When compromised, the tough outer layer of the disc can bulge or herniated. This means either the outer layer pushes outward (bulge) or the soft inner layer leaks out (herniated).
A cervical pinched nerve is often more painful and possibly more severe than an impinged low back nerve. Why? Because the cervical spine is a very mobile part of the spine and the structures are smaller.
When a cervical disc bulges or herniates, nerve roots may become irritated and possibly impinged causing neck pain that radiates (travels) into the shoulders, upper back and arms.
Some patients may derive pain relief from over-the-counter anti-inflammatory medications. It is important to understand that it is not uncommon for a disc to naturally resorb – pull back into normal position within the upper and lower vertebral bodies. Pain and related symptoms may diminish. However, sometimes neck and upper body pain does not resolve, becomes persistent, and may worsen.
An epidural injection is a common treatment to relieve cervical pain associated with a herniated disc. The goal of the epidural is to relieve neck pain, as well as pain that radiates into the shoulders, upper back and arms.
An epidural injection is performed using fluoroscopic guidance — a fluoroscopy unit is similar to real-time x-ray. Using fluoroscopy, a very small needle is guided as close to the disc herniation as possible.
The needle enters the epidural space and a very small amount of local anesthetic and steroid is injected. Because the needle is precisely placed within the irritated area, only a small amount of medication is needed. Most patients achieve good pain relief (minutes to days) after a procedure.
If you are interested in an evaluation into the cause of your neck pain, or a cervical epidural injection to manage your pain, please contact our pain management experts at The Spine and Pain Institute of New York in Manhattan, New York and Staten Island, New York. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.