• Nerve Root Block

    1. What is a nerve root block?

    A nerve root block is an injection of local anesthetic and/or steroid 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 arm or leg pain that follows the path of a single nerve. The pain may be due to irritation or inflammation of that nerve, whether from prior operations or recent disc herniations.

    A nerve root block may have diagnostic or therapeutic value. One of three things will happen:

    1. The pain does not go away, which means that the pain probably is not coming from the nerve at the level of the injection. This is of diagnostic value.
    2. The pain goes away and stays away for a few hours, but then comes back and does not get better again. In this case, the block is also of diagnostic value, as it means the pain probably is coming from the nerve at the level of the injection, but the steroid was not of benefit.
    3. The pain goes away after the block and may come back later that day, but then it improves again over the next few days. This means that the block was of therapeutic value, because the steroid had a long-lasting effect on the pain.

    If you get a good, lasting benefit from the injection, the block may be repeated. Sometimes your surgeon will ask that the block be done to help identify whether or not surgery might be helpful, and if so, where would it be most helpful.

    Please note: This procedure cannot be performed if you have an active infection (and are on antibiotics), flu, fever, extremely high blood pressure, or if you are on blood thinners (e.g., aspirin, Coumadin, Plavix, Pletal). Blood thinners must be stopped five to seven days prior to the procedure. For your safety, please inform us if any of these conditions exists.

    2. What are the risks of the procedure?

    As with most procedures, there is a remote risk of bleeding, infection, nerve injury or allergic reaction to the medications used. Some short-term side effects may occur, as well. You should experience some numbness that follows the path of the nerve that was blocked, if local anesthetic was injected onto the nerve. If just a steroid was used, you will not experience this sensation. You may feel some weakness, as well. If you experience weakness that interferes with your ability to walk, you will remain in recovery until the problem resolves. You may have increased pain for a few days after the injection, including localized pain at the injection site. Diabetics may have a short-term elevation of blood sugars.

    3. What happens during the procedure?

    After you check in and sign a consent form, your vital signs will be taken. You will then be taken to the procedure room. Please wear loose-fitting clothing. You may be asked to change into a hospital gown.

    In the procedure room, our nursing staff will position you on your stomach on a narrow table. Your back will be cleaned with iodine and sterilely draped. Then, the doctor will numb your skin with a small needle, which will sting just a bit. It is very important to hold still and let us know if we are causing you discomfort. Next, the doctor uses an X-ray machine (fluoroscope) to guide the needle into the correct spot. A dye may be injected at this point. Please let the doctor know if you have an allergy to dye. Local anesthetic and/or steroid is then injected through the needle, and the needle is removed. Your skin will be cleaned and a Band-Aid applied. (The Band-Aid may be removed the next morning). The procedure will last 10 to 15 minutes.

    Your pain may improve immediately after the injection, due to the local anesthetic. It is important to keep track of how you feel for the remainder of the day. The steroid usually takes two or three days to have an effect in most people and peaks in about two weeks. It is important that you keep track of the amount of pain relief you receive, as well as how long it lasts.

    4. What happens after the procedure?

    You will be taken to the recovery area in a wheelchair. You will remain in the recovery area for 15 minutes. Your vital signs will be taken, and as soon as you can walk without any weakness, you can be discharged. If you have local tenderness from the needles, ice may help relieve the discomfort. You can also resume taking your normal pain medications.

    5. Will I have any restrictions after the procedure?

    Following your procedure, you are not allowed to drive for the remainder of the day. An adult must be present to drive you home or to escort you on another form of transportation. This is for your own safety. In addition, do not go swimming or soak in a tub or Jacuzzi on the day of your procedure. Otherwise, you may do whatever you feel up to doing.

    6. For what reasons should I call the Pain Management Center after the injection?

    You should call us immediately at 781-744-5090 if you experience any of the following:

    • Severe back pain that is not relieved with medication and ice
    • Prolonged, new numbness or weakness of your legs
    • Loss of control of your bladder or bowels
    • Signs of infection in the area of injection

    Things to Do Before the Procedure

    • Any dietary restrictions will be discussed on the day the procedure is booked.
    • Take all of your medications as scheduled on the day of the procedure, unless directed otherwise.
    • Think of any questions for us and write them down.
    • Make the nurses and doctors aware of any new changes in your medical condition.
    • Before you come in, let us know if you are taking any blood thinners (e.g., aspirin, Coumadin, Plavix, Pletal) or anti-inflammatories.
    • Please remember to arrange for an adult to drive you home.
  • Make an Appointment

    (781) 744-5090