If medication does not eliminate your neck pain, NYU Langone doctors may recommend therapeutic injections of pain medication before considering surgery. NYU Langone has a dedicated team of pain management specialists who provide these injections.
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If neck pain is caused by a pinched nerve or a herniated disc, your doctor may recommend a corticosteroid injection. Most of the time, doctors recommend injections only after other conservative treatments, such as steroid medications, have not brought relief.
Steroids have powerful anti-inflammatory properties. They can be injected directly around a nerve in the spine during a procedure called a nerve block, or into the spinal canal around the fluid-filled space that surrounds the spinal cord in a procedure called an epidural injection.
Doctors perform these injections while you are under local anesthesia, and our pain management specialists and radiologists use X-rays to ensure the steroids are injected in the correct location. The procedure typically takes less than 30 minutes.
Pain relief from injected steroids may last anywhere from a week to a year or more. However, some people find that injections don’t help at all. Unfortunately, there is no way to predict the effectiveness of an injection. For many people, steroids do provide long-lasting relief.
Steroid injections are most effective when used just before you start physical therapy, enabling you to begin your strength-building exercises without pain. If steroid injections don’t eliminate pain, surgery may be the next step.
Epidural steroid injections allow doctors to inject medicine directly into the spinal canal around the fluid-filled space surrounding the nerve roots and spinal cord. They are helpful for people who have a pinched nerve or cervical spinal stenosis. The medicine is a combination of corticosteroids and a local anesthetic, which together reduce inflammation in the spinal canal and relieve pain. At NYU Langone, pain management experts use live video X-rays to guide the needle to the correct location in the spine.
These injections typically take effect in 48 to 72 hours, but they may take up to a week to relieve pain. Relief may last weeks or months, though epidural injections may not work for some people. There is no reliable way to predict whether an injection may work for someone.
Doctors give people local anesthesia before performing an epidural injection. The procedure takes about 30 minutes. Most people experience few side effects, aside from soreness at the injection site, and can return to normal activities the following day.
Facet joints are the joints that connect the spinal bones, called vertebrae, along the spine. These joints provide the spine with flexibility and movement. If any of these joints become irritated or inflamed—due to osteoarthritis of the spine, for instance—the thickened and enlarged joint can encroach into the neural foramen and press painfully against nearby nerve roots.
A facet joint injection, also called a facet block, is an injection of local anesthesia and corticosteroids that doctors place directly into the affected joint. The anesthesia provides temporary pain relief, and the corticosteroids reduce inflammation in the joint and the affected nerve roots.
Doctors use a special X-ray device called a fluoroscope, which provides live images of the spine and joints, to ensure that the injection is guided to the facet joint. The procedure takes between 15 and 30 minutes. Most people have no side effects, return home the same day, and can resume normal activities the following day.
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