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Nerve Root Block

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A nerve root block is a procedure that involves injecting local anesthetic and a steroid into the area where the nerve exits the spinal column to treat pain in the arm or leg that follows the path of a single nerve.

The injection may also be performed to determine the source of the pain. If the patient experiences pain relief following the injection, then the procedure may be repeated.

Side Effects and Risks

A nerve root block is a relatively safe procedure. Patients may experience temporary weakness and soreness or numbness at the injection site. Serious and rare complications include bleeding and infection at the injection site, muscle or nerve damage, and allergic reaction. Patients with diabetes may have high blood sugar for a short time because of the steroid medication.

Who is a Candidate?

A nerve root block may be a good option for patients who have not responded to other treatment.

The procedure is contraindicated for patients with an active infection, fever, flu or cold. Patients with high blood pressure and those taking blood thinners should consider other treatment options.

How to Prepare for the Procedure

Patients should avoid eating or drinking after midnight the night before the procedure. Patients may take medication with a small amount of water, but diabetics may be advised to stop taking their medication for diabetes until the procedure is completed. In addition, patients taking any blood thinners such as Coumadin, Plavix and Warfarin will need to stop taking their medication until after the procedure.

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What to Expect During a Nerve Root Block Procedure

Once the patient arrives at the facility, they will be asked to rate their pain. The patient will then lie down on their stomach on an x-ray table and the physician will cleanse the patient’s lower back. He or she may offer intravenous medication to help the patient relax.

Under x-ray guidance, the physician will insert a thin needle into the patient’s lower back and inject a local anesthetic and dye to confirm proper needle placement. A second needle will be inserted and the anesthetic and steroid will be injected.

Patients will be monitored for about 20-30 minutes to make sure their vital signs and temperature are normal. After that, patients will receive verbal and written discharge instructions and will be allowed to go home with their driver.

After the Procedure

Patients may experience significant pain relief immediately after the injection as a result of the local anesthetic. The steroid will begin to take effect two to three days after the injection, with pain relief peaking in about two weeks.

Patients experiencing tenderness at the injection site may use an ice pack to alleviate this. Patients may resume taking their pain medication after the injection but should keep track of the pain relief they experience and how long the pain relief lasts.

It’s important to avoid applying heat to the injected area; no hot showers, hot tubs or soaking in water for the rest of the day. For a few days after the procedure, patients should avoid engaging in strenuous physical activity.