A nerve root injection is a procedure where medication (steroid and anesthetic) is deposited near the nerve as it exits the spinal canal. This is performed using live X-ray or fluoroscopy to identify the precise location. Contrast dye is injected and techniques are utilized to ensure proper medication delivery
Am I a candidate for a selective nerve block?
Your Pain Doctor along with your referring physician will determine if you are appropriate for an epidural injection. Usual conditions treated by nerve blocks include herniated or bulging discs, sciatica, spinal stenosis, degenerative disc disease, neuritis, pain associated with compression fractures.
What are the benefits of nerve root injections?
Nerve root injections can reduce irritation, inflammation, and provide pain relief.
How long does the procedure take?
The entire procedure will take approximately 10 minutes.
Where is the procedure performed?
It is typically done in an office or surgical suite using fluoroscopy.
How is the procedure performed?
Typically an IV is started so that the anesthesiologist can administer sedating medication to make you comfortable. Your doctor will typically identify the area he will be injecting using the X-ray machine, and then provide some local numbing medication (Lidocaine) before placement of the needle. The spinal needle is advanced using x-ray guidance at the opening of the spine where the nerve exits. Needle position is confirmed with the injection of contrast dye, and anatomical identification via the live X-ray images. The dye will not be used if there is an allergy. Once needle placement is assured, the therapeutic solution is injected.
How many nerve root injections do I need?
It depends upon the location and cause of the pain.
What if I am afraid of needles?
Typically patients with needle phobia do just fine with sedation to help relax them. They also typically will have little to no memory of the actual procedure.
Is it painful?
Generally no, your doctor will do everything possible to minimize and discomfort during the procedure. This may require sedation and is typically achieved with the numbing medication (lidocaine).
What are the risks and side effects?
The procedure is generally safe. However, with any procedure or medications there are potential risk, complications, and side effects. The potential risks to a certain degree depend on the region of the nerve block and an individual’s body variations. Whenever a needle is introduced through the skin there is risk of infection, bleeding, and soreness. For this reason, all our procedures are performed under sterile technique, and a careful history is taken to ensure any risks of bleeding are minimized. On occasion, one may develop numbness do to extensive spread of the local anesthetic. Rarely, an individual can develop a “spinal headache,” this typically occurs 1% of the time. And is more common in younger individuals. Bleeding into the spinal canal on extremely rare occasions can occur. This is referred to as an “epidural hematoma;” this is why it is essential for you to make us aware of any blood thinner medications you are taking; as this can lead to spinal cord and nerve damage. Recently, the FDA issued a black box warning on epidural steroid injections this does not necessarily pertain to Selective Nerve Blocks as there is technically no violation of the epidural space. Making them in fact in some ways less riskier then a more traditional trans-foraminal epidural steroid injection Please see Informed Consent Documents for further information on the warning associated with epidural steroid injections. All complications are extremely rare.
How long does a nerve block last?
A person’s response will vary depending on their underlying condition, severity of illness, and lifestyle. Some people have a single injection. Others have a partial response, and may require additional injections to achieve more robust improvement. Some fail to respond completely. You will be re-evaluated following your initial injection by your doctor.