Cervical Thoracic and Lumbosacral Nerve Root Block
What is a nerve root and why is a selective nerve root block helpful?
Nerve roots exit your spinal cord and form nerves that travel into your arms or legs. These nerves allow you to move your arms, chest wall and legs. Inflammation of these nerve roots may cause pain in your arms or legs. These nerve roots may become inflamed and painful due to irritation, for example, from a damaged disc or a bone spur. A selective nerve root block provides important information to your physician and may provide long term relief. It serves to prove which nerve is causing your pain by placing temporary numbing medicine over the nerve root of concern. If your main pain complaint improves after the injection, that nerve is most likely causing your pain. If your pain remains unchanged, that nerve probably is not the cause of your pain. By confirming or denying your exact source of pain, it provides information allowing for proper treatment, which may include limited surgery at a specific location.
The procedure serves both diagnostic and therapeutic purposes.
What happens during the procedure?
While lying on a table, the skin over your spine will be well cleaned. The physician will numb a small area of skin with numbing medicine which stings for a few seconds. Next, the physician will use X-ray guidance to direct a very small needle just next to the nerve root without injuring the nerve root. He will then inject contrast dye to confirm that the medicine flows around the nerve root. This may temporarily increase your usual pain. Then, anti-inflammatory steroid (with or without local anesthetic) will be injected along the nerve root to improve your pain, if that nerve is the source of your pain.
What happens after the procedure?
A dressing may be applied to the injection site. You will remain in the office for about 15-20 minutes and the nurse will monitor your blood pressure and pulse. The nurse will review your discharge instructions and you will be able to go home. You may experience numbness or weakness to the affected limb for a few hours after the procedure. If this happens do not walk without assistance. Your physician may refer you to a physical therapist while the anti-inflammatory steroid is still working.
General Pre/Post Instructions
You may eat a light, but not full meal at least one hour before the procedure, unless receiving intravenous sedation. If you are an insulin dependent diabetic do not alter your normal food intake.
Take your routine medications before the procedure (such as high blood pressure and diabetes medications) except for those that need to be discontinued five days before the procedure such as aspirin and all anti-inflammatory medications (e.g. Motrin/Ibuprofen, Aleve, Relafen, Daypro). These medicines may be re-started the day after the procedure. You may take your regular pain medicine as needed before/after the procedure. If you are taking Coumadin, Heparin, Lovenox, Plavix or Ticlid you must notify the office so that the timing of stopping these medications can be explained.
You must bring a driver with you. You may return to your current level of activities the next day including return to work.
Things that may Delay the Procedure
If you are on antibiotics please notify our office; we may delay the procedure. If you have an active infection or fever we will not do the procedure.