Expert: Dr Ian Jackson - please note UK based - 2/22/2009

Question
I have chronic cervical spondylosis affecting C5-6 that gives much pain and parasthesia. I have now had 3 epidurals - one several years ago was very successful where the consultant injected into the C5-6 space. The two recent ones at another place, the consultant injected into C7-T1 stating each time that the affected spinal levels further up the neck would be affected. Each time there has been no difference noted and I am beginning to think it has been a waste of time - I am very confused. Is there any rationale behind this. Many thanks for your help.

Answer
Hi John
First I must point out I am careful to state that the management of chronic pain is beyond my expertise!
My understanding of epdural injection of steroids for chronic back problems is that they only work in some people - and even in the same person they may work on some occasions and not on others.
It may well be that your condition has deteriorated so that the steroid is no longer helpful to the nerves that are being irritated.
Typically an injection at C7-T1 would reach the affected area.
However there is just a chance that you are correct and the drugs are just not quite reaching the spot.
However that issue is beyond my speculation.
Kind regards
Dr Ian Jackson