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Nerve root blocks

A nerve root block is an injection into the sheath surrounding a nerve root in the spine to decrease your pain temporarily and to define it more precisely. The exam uses therapeutic steroid and local anesthetic (numbing medication) to decrease pain and inflammation. Pain relief from the procedure varies depending on the specific symptoms.

You must have symptoms present for this procedure to be effective.

Procedure Preparation

There is very little preparation needed for this procedure. In fact, you may decide to go ahead with this procedure during your initial consultation in our Midtown Manhattan outpatient clinic. The procedure will be fully explained to you before you decide to proceed.

Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs to your initial appointment. If you do not have current images, we may refer you to have them done prior to the procedure.

If you come by car, you will need a driver to take you home after your appointment. You will be able to go home unaccompanied via subway or taxi.

Please notify our physician if you are nursing or if there is a chance you may be pregnant.

Please be prepared to discuss any medications that you are currently on with our physician, or bring you medication bottles with you to your appointment.

During the Procedure

You will remain awake throughout the procedure.

A physician will use a thin needle to place anesthetic (numbing) and steroid (anti-inflammatory) medication into the nerve sheath. There may be minor discomfort from the needle.

The physician checks the needle position using x-ray-guidance (fluoroscopy) to ensure accurate placement of the needle.

Contrast (dye) is placed into the nerve sheath to document the needle position and x-rays are taken.

During the injection, you may feel pressure or pain. The physician will want to know how this discomfort compares to your usual pain symptoms.

After the Procedure

There is very little recovery time after this procedure. Many patients return to work the same day.

You may experience numbness from your symptoms for up to six hours after the injection.

Your usual symptoms may then return and may possibly be worse than usual for a day or two.

The beneficial effects of the steroids usually require 2-3 days to be effective; in some cases it may take as long as 5-7 days. If there is no change in your symptoms after a week, consult with your doctor to investigate other possible causes of your pain.

If an initial injection provided a certain amount of relief, a second injection might strengthen the pain relief effect (known as "stacking"). Some patients have relief in the first few weeks, but if the pain returns in the following weeks and months, additional injections will increase your pain relief.

Keep track of how long your relief lasts and report it to your physician. If there is no change in the pain, we can be focus on other possible sources of your pain. The effects of the treatment are an important part of determining the problem and planning future treatment programs.

A full course of physical therapy will help you to fully recover, strengthen your back and core muscles, and maximize your recovery.

Possible side effects

Although side effects from this procedure are rare, our physician will review any possibilities with you before your procedure. Possible side effects include facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating. These side effects occur in less than 5% of patients and usually disappear within 1-3 days after the injection. If you experience any side effects, please feel free to contact us at any time.