Epidural steroid injections for the treatment of cervical radiculopathy in elite wrestlers: case series and literature review

Abstract

Background: Elite wrestlers place tremendous stress through their cervical spine. These athletes are at risk for cervical trauma and may develop radiculopathy from recurrent episodes of injury. Team physicians and athletic trainers are faced with the challenge of treating these injuries in such a way as to allow the athlete to safely and expeditiously return to competition. Epidural steroid injections can be a successful complement to a conservative treatment algorithm for these complex injuries.

Study design: Case Series.

Methods: Five upper-level NCAA collegiate wrestlers who experienced symptomatic cervical radiculopathy were identified from an archival review. The majority of the athletes had MRI evidence of cervical disc disease, with corresponding subjective complaints and physical examination findings including pain and weakness that precluded continued competition. All athletes were treated conservatively with initial activity modification, strengthening, rehabilitation, NSAIDs, and, ultimately, cervical epidural steroid injections.

Results: All five athletes successfully returned to competition without negative clinical sequelae or need for operative intervention. The athletes demonstrated subjective improvement in their symptoms and strength, and all were able to return to a high level of competition. The cervical epidural steroid injections were found to be safe, effective, and well tolerated in all of the athletes.

Conclusions: Elite wrestlers with cervical radiculopathy can be effectively and safely managed with a conservative regimen that includes cervical epidural steroid injections, which may allow them to continue to compete at a high level.

Figures

Figure 1. Sagittal and axial images from MRI demonstrating disc extrusion at C3-C4 with resultant foraminal stenosis and root compression on the right.

Figure 2. Sagittal and axial MRI images demonstrating disc extrusion and left-sided foraminal compression at C6-C7.

Figure 3. Sagittal and axial images from MRI demonstrating disc extrusion

Figure 4. Sagittal and axial images from MRI demonstrating disc extrusion