A nerve root block injection is designed to diagnose and alleviate nerve pain by reducing inflammation. If you have conditions like sciatica or a herniated disc, this procedure might help. In this article, learn about its benefits, procedure, and risks.
Key Takeaways
Nerve root block injections are used both diagnostically and therapeutically to manage nerve-related pain, especially in conditions like sciatica, herniated discs, and scoliosis.
The procedure involves injecting a local anaesthetic and steroid under x-ray or ultrasound guidance to ensure precise delivery of the medication, providing both immediate and long-term pain relief.
Understanding Nerve Root Block Injections
The human spine comprises 26 vertebrae with spinal nerves situated between each. These nerves, including those running on either side of the lumbar spine, carry essential messages for sensation and movement throughout the body. When these nerves become irritated or inflamed, it can lead to significant pain and discomfort. This is where nerve root block injections come into play.
A nerve root block injection involves:
Injecting a small amount of local anaesthetic and steroid onto one or more of the affected nerves
The local anaesthetic works to numb the injection site, providing immediate relief
The steroid helps reduce inflammation and pain over time
Nerve root block injections primarily serve two main functions: they provide valuable diagnostic information for the doctor and offer pain relief. By temporarily numbing the nerve, doctors can determine if that particular nerve is the source of the patient’s pain.
Additionally, the injection can offer significant pain relief, allowing patients to resume normal activities and improve their quality of life.
During administration of a nerve root block injection, image guidance is used to deliver the medication accurately where needed. This precision is typically achieved using x-ray guidance or ultrasound to visualize the needle placement and confirm the correct location before the medication is administered.
Reasons for Needing a Nerve Root Block Injection
Nerve root block injections are multifunctional, which makes them a versatile tool for managing nerve-related pain.
One of the primary reasons for undergoing this procedure is to diagnose the precise source of a patient’s pain.
In addition to their diagnostic use, nerve root block injections are also therapeutic. Patients often notice a significant symptom improvement when the inflammation and pain around the nerve decrease, which enables them to resume their normal activities.
Certain medical conditions make nerve root block injections particularly beneficial. For instance, patients suffering from a herniated disc or degenerative changes in the spine often find relief through these injections.
In cases of scoliosis, where the spine curves abnormally, nerve root block injections can help manage the pain associated with inflamed nerve roots. This procedure offers a targeted approach to pain relief, addressing the specific nerves that are causing discomfort.
Given their capacity to diagnose and treat nerve-related pain, nerve root block injections are a useful option for many patients. Whether used to identify the source of pain or to provide long-lasting relief through nerve root blocks, these injections can significantly improve a patient’s quality of life.
Patients can visit a pain clinic for nerve root block injections and other pain management procedures.
The Procedure: Step-by-Step with X Ray Guidance
The nerve root block procedure is typically performed in a day case clinical area or an outpatient setting, ensuring convenience for the patient.
When you arrive, you will be asked to lie on your stomach on the table, which allows the doctor to have clear access to the injection site. The area where the injection will be given is thoroughly cleaned with antiseptic to prevent any risk of infection.
Image guidance (Xray or Ultrasound) is integral to this procedure. This ensures that the needle is placed precisely in the correct location. This step is important for maximizing the injection’s effectiveness and minimizing potential risks.
When using an x ray machine, a special dye, known as contrast dye, is often injected around the nerve root to confirm the correct needle placement before administering the medication. This additional step ensures that the medication will be delivered exactly where it is needed to provide maximum relief.
The entire procedure is usually quick, lasting about 15 to 30 minutes, and patients can expect pain relief within a few hours. Patients are generally awake during the process, which allows for immediate feedback if any discomfort or unusual sensations occur.
Adopting such a methodical approach makes the injection safe and effective, optimizes pain relief and diagnostic accuracy.
What is Injected?
Nerve root block injections typically involve the use of two main substances: a local anaesthetic and a steroid or alternative anti inflammatory medication.
The local anaesthetic is used to numb the area before the nerve root block is injected. This provides immediate relief of symptoms by blocking the pain signals from the affected nerve. The sensation of numbness can be a welcome respite for patients who have been dealing with chronic pain.
The steroid component of the injection serves a different but equally important role. Steroids work by:
blocking specific nerve fibers that transmit pain signals to the brain
reducing the inflammation around the nerve, providing longer-term relief
This combination of immediate and sustained pain relief makes nerve root block injections a powerful tool in managing chronic nerve pain.
Preparing for Your Injection
Proper preparation is crucial for a smooth and successful nerve root block injection procedure. Patients are generally allowed to eat and drink normally before the procedure, which helps to maintain a sense of normalcy and reduce anxiety. A pain consultant will provide guidance on eating and drinking instructions, as well as discuss potential risks and complications before the procedure.
However, it’s important to inform the medical staff about any medications you are taking, as some may need to be adjusted or stopped prior to the procedure. This includes antibiotics, aspirin, warfarin, or clopidogrel, which could affect the procedure or recovery.
Special considerations for diabetic patients include:
Informing the doctor about your diabetic status
Continuing to monitor your blood sugar levels carefully for several days after the injection
Taking your usual medications on the morning of the procedure and bringing them with you
Patients should also inform the Doctor if they:
are feeling unwell
have an infection, cold, or persistent cough
have any allergies
are pregnant
By following these guidelines, patients can help ensure that the procedure goes smoothly and that any potential complications are minimized.
During the Injection: What to Expect
The skin will be cleaned before the injection. Then a small amount of local anaesthetic will be injected under the skin. This initial injection might sting for a few seconds. As the needle is guided to the correct location using x-ray or ultrasound, you might feel a sharp pain going down your leg briefly if the needle touches the nerve. This sensation is temporary and indicates that the needle is close to the target nerve.
During the actual injection of the pain-killing medicine, you might experience a sensation of pressure or discomfort as the medication flows. This is normal and usually subsides quickly. The entire process is designed to be as quick and painless as possible, providing you with both immediate and long-term relief.
Post-Injection Care and Recovery
Patients can usually go home shortly afterwards. Feeling numb or weak in your leg for up to 24 hours after the injection is a normal occurrence. It should improve over time. This temporary numbness is a result of the local anaesthetic and should wear off within a day.
Post-procedure soreness or discomfort is also normal and should subside within a few days. However, patients should:
Avoid taking a bath for the first twenty-four hours after the nerve root block injection
Not drive on the day of the procedure
Avoid strenuous exercise for about 4-7 days post-injection.
Diabetic patients should continue to monitor their glucose levels for up to one month after the injection. Each patient’s reaction to a nerve root block is different, and some may require a series of injections for optimal relief. Maximum improvement is generally observed within three-six weeks after the injection.
Risks and Complications
As with any medical procedure, nerve root block injections carry potential risks and complications. One possible risk is infection at the injection site. To minimise this, the injection site is thoroughly cleaned with antiseptic before the procedure.
Another potential complication is an allergic reaction to the anaesthetic or other medications used. Temporary muscle weakness is also a possibility. Additionally, bleeding or bruising at the injection site can occur.
Although these possible risks are relatively rare, awareness and discussing any concerns with your doctor before the procedure are essential.
Success Rates and Effectiveness
The success rates of nerve root block injections exhibit significant variability, with rates ranging from 46% to 84%. This variability can be attributed to factors such as the duration of chronic pain, the patient’s age, and the presence of concurrent treatments.
Patients who participate in physical therapy or rehab often experience higher pain-relieving effects. This combination of treatments, guided by the clinician, can enhance the effectiveness of the nerve root block injection, providing more significant improvement in symptoms.
Approximately 50% of patients who receive a nerve root block injection at an early stage may not require further procedures. This highlights the importance of early intervention in managing chronic pain effectively.
Summary
Nerve root block injections offer a targeted and effective solution for diagnosing and treating nerve-related pain. By combining immediate pain relief from local anaesthetics and the long-term anti-inflammatory effects of steroids, these injections can significantly improve a patient’s quality of life.
Whether used for diagnostic purposes or as a therapeutic intervention, nerve root block injections provide a valuable option for managing chronic pain. By following the preparation and post-injection care guidelines, patients can optimize their outcomes and enjoy a better quality of life.
Frequently Asked Questions
What is a nerve root block injection?
A nerve root block injection involves injecting a local anaesthetic and steroid onto affected nerves to provide pain relief and diagnostic information. It is a common procedure used to alleviate pain caused by compressed or irritated nerves.
Why would I need a nerve root block injection?
You may need a nerve root block injection to diagnose the source of pain, alleviate leg pain and paraesthesia, and treat conditions like herniated discs and scoliosis. It can also help in alleviating back pain.
What should I expect during the procedure?
At MyMSK Clinic we offer an initial consultation where the doctor takes a patient history and if necessary may also do a physical examination of the concerned area. If a Nerve Root Injection is suitable this can be done during the same consultation. The consultation usually lasts around 45 mins to 1 hour.
What are the risks and complications?
The risks and complications of the procedure may include infection, allergic reactions, temporary muscle weakness, and bleeding or bruising at the injection site. It is important to discuss these risks with your healthcare provider before undergoing the procedure.
How effective are nerve root block injections?
Nerve root block injections can be effective, with success rates ranging from 46% to 84%, especially when combined with physical therapy and exercises.
Can I Book a Nerve Root Block Injection?
Yes! Initially our Experienced Clinician assesses the patient during a consultation in our clinic in Manchester City Centre. Once we feel comfortable the clinician may suggest a nerve root injection depending on the outcome of the examination. The injection can be done on the same day using Ultrasound Image Guidance to ensure it is as accurate as possible.
To Arrange a consultation please just visit our Booking Page or call us at 0333 772 9655 . Alternatively you may wish to email us ‘admin@mymskclinic.co.uk’.
