A selective nerve root block is an injection of a local anesthetic and a corticosteroid under real-time x-ray. The medications are injected into the area where the selected nerve exits the spinal column.
Why is a selective nerve root block done?
A selective nerve root block is used for pain in the leg or arm when the pain follows a single nerve pathway. A block can be diagnostic, meaning it’s used by the doctor to test and determine the exact source of the pain, or the block can be therapeutic, meaning its used to relieve the pain. Sometimes, a selective nerve root block is used to identify if surgery will help your condition and at what level the surgery should be done.
How do I prepare for the procedure?
If you are on any blood-thinning agents, notify the doctor of these prior to the procedure, as certain drugs must be held for several days. When you arrive at the clinic, a nurse will discuss the procedure pros and cons and ask you to sign a consent form. After changing into a gown, the nurse places an IV in your hand/arm to administer necessary medications and fluids.
Will the selective nerve root block hurt?
A mild sedative is given to keep you comfortable, and many patients do not report any pain. However, some people report a burning sensation when the skin is numbed using a local anesthetic. A few people report feeling a mild stinging of the affected area when mediation is injected near the nerve.
What are the risks of the procedure?
As with all minimally invasive procedures, there are a few risks to consider. Remote risks include infection, bleeding, nerve injury, and allergic reaction to solutions and medications used during the procedure. Short-term side effects include numbness of the injected area, weakness on the affected side, drowsiness, and dizziness. Side effects only last 20-60 minutes, however.
How is the selective nerve root block done?
After being positioned in the surgical room, your skin is cleaned with an antiseptic solution. The physician numbs the skin using a small needle and anesthetic agent. Using x-ray guidance, a needle is positioned near the targeted nerve and the medications are instilled into the area. After the block is done, the needle is removed and a bandage is applied to the area.
What can I expect after the injection?
After the nerve block procedure, you are moved to a recovery area where a nurse monitors your condition for 30-45 minutes. The pain is usually gone after the injection due to the local anesthetic. It takes 2-3 days for full effectiveness of the corticosteroid. As the anesthetic wears off, you may feel some tenderness and soreness at the injection site.
To alleviate this discomfort, we recommend using ice packs for 20-minute intervals several times each day. Once you are stable, you are allowed to leave the facility. You cannot drive, so arrange to have someone take you home.
What activity restrictions follow the procedure?
We recommend that you rest for the remainder of the day, and take it easy for 1-3 days following the block. Do not use heat on the area, and avoid soaking in a tub or pool for a few days. You can resume normal medications and diet, but should gradually return to activities.