Epidural Steroid Injections for Neck Pain

Syringe medication injection and needle in hand nurse asian for giving patient vaccine prophylactic / Medication drug bottle equipment medical tool for doctor liquid drug health care in hospital


Epidural Steroid Injections (ESI’s) should be considered when more conservative measures have failed, although the research shows they are not more effective than other measures, don’t reduce the likelihood of surgery, and are expensive. These injections of steroid are used to reduce inflammation and flush inflammatory chemicals into the area where the nerves leave the spinal cord.

Epidural steroid injections (ESI) are widely used for “radicular” or radiating pain, where nerve roots are affected causing pain, typically into the arm or upper back. They are usually tried when more conservative methods fail.

RESCU Treatment Ratings

R = Risk      E = Effectiveness      S = Self-Care

C = Cost     U = Usefulness (overall rating)

1 = Least Favorable     5 = Most Favorable


RISK: 1/5


The FDA has recently issued a warning notice regarding ESI’s, noting:

  • Rare but serious problems have occurred after injection of corticosteroids into the epidural space of the spine to treat neck and back pain, and radiating pain in the arms and legs.
  • These serious problems include loss of vision, stroke, paralysis, and death.
  • The effectiveness and safety of injection of corticosteroids into the epidural space of the spine have not been established, and FDA has not approved corticosteroids for this use.
  • Discuss the benefits and risks of epidural corticosteroid injections with your health care professional, along with the benefits and risks associated with other possible treatments.
  • https://www.fda.gov/Drugs/DrugSafety/ucm394280.htm

The FDA’s Anesthetic and Analgesic Drug Products Advisory Committee concluded that ESIs should not be recommended in the cervical region.




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