CLINICAL REPORT Cervical Epidural Injection in the Management of Refractory Pain and Stiffness in Spondyloarthropathy: A Case Report Series Semih Gungor, MD*; Rohit Aiyer, MD † ; Doruk Erkan, MD ‡ *Division of Pain Medicine, Department of Anesthesiology, Hospital for Special Surgery–Weill Cornell Medicine, Cornell University, New York, New York; † Department of Psychiatry, Hofstra Northwell Health, Staten Island University Hospital, Staten Island, New York; ‡ Division of Rheumatology, Department of Internal Medicine, Hospital for Special Surgery–Weill Cornell Medicine, Cornell University, New York, New York, U.S.A & Abstract Objectives: The primary objective of this case series was to report the use of cervical epidural steroid injection in the management of neck pain and stiffness secondary to spondy- loarthropathy in cases refractory to conservative therapy. Methods: This was a case report series on three patients with diagnosis of spondyloarthropathy who presented with severe stiffness and non-radicular axial neck pain refractory to conservative therapy. All patients received cervical epidu- ral steroid injections with significant improvement of their axial neck pain and stiffness. Results: Cervical epidural steroid injections may be effective to improve the axial neck pain and stiffness in patients with diagnosis of spondyloarthropathy refractory to conservative management. Thus, we believe that epidural steroid injec- tions should be considered in the management of patients with spondyloarthopathies. & Key Words: spondyloarthropathy, psoriatic arthritis, anky- losing spondylitis, neck pain, stiffness, epidural injection INTRODUCTION Epidural steroid injection is indicated in the manage- ment of cervical radiculopathy refractory to conserva- tive management. Use of epidural steroid injection in the management of cervical spine pain and stiffness without radiculopathy has not been described in the literature. In this case series, we describe the treatment of patients with cervical epidural injection, who presented with neck pain and stiffness secondary to spondyloarthropathy refractory to conservative man- agement. All 3 patients did not respond to conservative therapy with optimization of the medication manage- ment including high-dose oral steroids, activity modi- fication, home exercises, and physical therapy. One patient was diagnosed with ankylosing spondylitis, and 2 patients were diagnosed with psoriatic arthritis (PSA). Case 1 A 50-year-old female with a past medical history of PSA presented with neck pain. She developed psoriasis at age 7, and was diagnosed with PSA at age 14 due to severe neck and right knee pain. Her family history was remarkable for psoriasis and PSA diagnosed in her brother, sister, and both grandmothers. She was initially Address correspondence and reprint requests to: Semih Gungor, MD, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, U.S.A. E-mail: gungors@hss.edu. Submitted: April 4, 2017; Revision accepted: July 20, 2017 DOI. 10.1111/papr.12616 © 2017 World Institute of Pain, 1530-7085/16/$15.00 Pain Practice, Volume , Issue , 2017 –