A nerve root block is a common injection primarily used to diagnose the specific source of nerve root pain. Secondarily, it is used for therapeutic relief of pain in the neck, shoulders and arms caused by a pinched nerve or nerves in the cervical spine. It can be used to treat conditions such as herniated discs, spinal stenosis and radiculopathy. When a nerve root becomes compressed and inflamed, it can produce back pain or leg pain. Occasionally, an MRI may not clearly show which nerve is causing the pain and a nerve root block injection is performed to help locate the source of pain. In addition to its diagnostic function, this type of injection for pain management can also be used as a treatment for a far lateral disc herniation, which is a disc that ruptures outside the spinal canal.
How is Nerve Root Block Performed?
This pain reduction procedure is performed with the patient lying face down or face up to expose the neck. The patient may be sedated, but conscious during the procedure. A region of skin and tissue of the neck is numbed with a local anesthetic for injection. A real-time x-ray device called a fluoroscope is used to guide a needle to the neural foramen space, which is the space between the vertebral bodies where spinal nerves travel through. Contrast dye is injected into the space to confirm that the needle is correctly positioned near the irritated nerve or nerves. Then, an anesthetic solution is injected into the foramen space to treat the irritated nerve.
What should be expected?
If the patient’s pain is relieved after the injection, it can be an indication that the back pain generator is the specific nerve root that has just been injected. Patients may experience numbness or relief for up to 6 hours afterwards, after which the previous pain symptoms may return. The steroid usually takes two or three days to have an effect in most people, peaking in about two weeks. Patients may also experience some local tenderness for a couple of days after the injection; using an ice pack three or four times a day will help alleviate this. Patients may take their usual pain medication after the injection. It is important to take note of the amount of pain relief that is received as well as how long the pain relief lasted.
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