Dr. Wei Lan is a Consultant Pain Physician
Selective Nerve Root Block Information
What is a Selective Nerve Root Block?
A Selective Nerve Root Block is an injection of anti-inflammatory medication (steroid) around a specific nerve root as it leaves the spine. Different nerve roots can be targeted depending on the location of your pain and your symptoms. A nerve root block is very similar to an epidural.
Why has a Selective Nerve Root Block been recommended and how do they work?
Very often, pain is caused by irritation, inflammation or compression of the nerves supplying the back and legs. This can be due to conditions such as disc herniation, spondylosis or spinal stenosis.
Nerve Root Blocks work by delivering steroids directly to the root of the nerve thought to be involved. The aim is to reduce inflammation in this nerve and, thus, help with your pain. It can also be used to diagnose the source of your pain - if you respond to a particular nerve root block, it suggests that this is the specific nerve root involved in your symptoms.
When can a Nerve Root Block not be given?
Because a Nerve Root Block injection is done under X-Ray guidance, you cannot have it if you are pregnant, as it could damage your baby. You must be 100% certain that there is no possibility of pregnancy when coming in for procedure.
Also, if you have an infection, burn or open wound of any kind, have recently had surgery or the flu vaccine or have very high blood sugars or blood pressure your procedure may be cancelled. If you are on blood thinners of any kind you must discuss this with the Pain Doctor, well in advance of your procedure date.
How effective is a Nerve Root Block?
A Nerve Root Block is being performed with the aim of reducing your pain and your symptoms and also, to hopefully, provide a window for some rehabilitation work such as physiotherapy/exercise.
Although how effective the injection will be for you cannot be determined in advance, many people will have some noticeable improvements in symptoms. Generally, it takes 1-2 weeks for the injection/injections to begin to work. Effects can last for weeks or months or sometimes years.
If they are successful, injections can be repeated but because they contain steroids, injections need to be spaced out as otherwise you run into the risk of developing side effects from the steroids.
Are there side effects/complications?
Nerve Root Blocks are generally considered safe procedures. However, like any medical procedure, there is a possibility of side effects/complications and you need to be aware of those.
Side effects include: Headache (usually gets better within a few days); low blood pressure (settles very quickly);Infection and Bleeding (rare); nerve damage (very rare);Allergic reactions. As already mentioned, high doses of steroids can also have side effects. Discuss any concerns with your Doctor
When the pain is improved and with the approval of your doctor, we very much encourage you to start regular exercise and activities as this will help with your overall pain management and mood – Remember, to do so in moderation and to increase activities and exercise gradually.
When can I resume normal activities/medications?
Activity:
Procedure Day: You are advised to rest on the day of your procedure.
Day2: Return to 25% to 50% of your usual activity level
Day 3: Return to 50% to 75% of your usual activity level.
After that, you can resume your normal activities as tolerated.
Medication:
Continue to take your usual pain medication until you notice some improvement in symptoms. Link in with your GP with regards to any medication changes.
Resume anti-coagulants the first day after the injection or follow your doctor’s specific advice.