Nerve Root Blocks
A nerve root block is an injection of local anesthetic and steroid. The procedure is performed under x-ray guidance into the area where the nerve exits the spinal column. A nerve root block is usually ordered by your doctor for pain in the arm or leg that follows the path of a single nerve. A nerve root block may be diagnostic (a test to determine the source of your pain) and/or therapeutic (to relieve your pain). The procedure may result in permanent or temporary relief from pain. If you get a period of sustained pain relief from the injection, the block may be repeated. The block can also be used diagnostically to help identify whether or not surgery might be helpful.
General Pre-lnjection Instructions:
Be sure to inform our staff if you have an allergy, particularly to iodine. If you will be receiving sedation, you should NOT eat the morning of the procedure. If a patient is an insulin dependent diabetic and receiving sedation, they may need to change their morning dose of insulin to account for not eating the morning of the procedure. Patients may take their routine medications (i.e., high blood pressure and diabetic medications, e.g. Glucophage).
Patients should continue to take pain medications or anti-inflammatory medications the day of their procedure. If a patient is on Coumadin or another blood thinner, they should notify the staff so an appropriate plan can be made for stopping the medication before the procedure. We generally recommend that a driver should accompany the patient and be responsible for getting them home.
Nerve Root Block Procedure:
An IV may or may not be started at the physician’s discretion. The patient is placed on their stomach on the procedure table and positioned in such a way that the physician can best visualize the bony openings in the spine where the nerve roots exit the spine using x-ray guidance. The skin in the appropriate area is scrubbed using antibacterial soap. Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle using x-ray guidance above the nerve root as it leaves the foreman. A small amount of contrast (dye) is injected to ensure proper needle positioning. Then, a small mixture of numbing medicine (local anesthetic) and anti-inflammatory (steroid) is injected.
What happens after the procedure?
There are no restrictions to food or liquid intake or to activity level unless specified by the physician. A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three, about one month apart. The back or legs may feel weak or numb for a few hours. This does not always happen, but is an expected possible temporary reaction to the procedure. Patients may return to their normal activities on the day of the procedure. Driving is discouraged on the day of the procedure.