Nerve Root Block Injection:
- A nerve root block is a minimally invasive technique which assists in diagnosing the cause and providing treatment from pain resulting from nerve root irritation. It can be used to treat pain in the cervical, thoracic and lumbar spine.
- Nerve Root Block Injection is given if a small disc bulge or wear and tear in spine with possible inflammation or irritation is causing localised radicular pain radiating to (both legs or arms) most commonly to lumbar region, where simpler measures haven’t helped. NRB injection is performed to assist in isolating the source of pain as well.
- NRB injection is a combination of a small amount of steroid (Anti Inflammatory) and local anaesthetic. Fluoroscopy (liveX-ray) is used to ensure the medication is injected to the correct place.
- Most people’s pain will settle in time without the need for surgery. In the short term, delivery of anti-inflammatory medicine directly to the source of irritation around the spinal nerve root is beneficial and can provide excellent pain relief and help your surgeon understand your condition.
PROCEDURE:
The procedure is carried out as a day case under local anaesthesia with the patient lying on their stomach and requiring hospital stay of 3-4 hours. The skin on the back is cleaned with antiseptic solution. Fluoroscopy (live X-ray) is used as guidance to direct the needle to the nerve root where it exits between the vertebral bodies before the combination of small volume of steroid and local anaesthesia is injected. There may be some temporary numbness or heaviness in the leg for a few hours after the injection, so care should be taken when first getting out of bed. Patients would get up and walk shortly after the procedure but driving is not permitted due to sedation.
Once the numbness has worn off often the pain returns, occasionally slightly worse, until the corticosteroid takes effect.
Injection takes up to 10 days to work at it’s full potential but starts showing results in 3 days. Technically, these injectional procedures must be performed by experienced doctors as they can go wrong if not performed in experthands.
Recovery from Nerve Root Block Injections:
After receiving a Nerve Root Block Injection, the patient is able to return home shortly thereafter, and resume regular activities the next day. During a follow-up visit in about two weeks, we try to gauge as of how effective the injection has
been in lessening symptoms. A patient is often encouraged to become involved in an exercise program that involves both stretching and strengthening exercises, which can enhance the effects of the Nerve Root Block injection. Some patients experience long-term, sometimes even permanent, pain relief after one injection and require no further treatment; others may need additional treatment a few weeks or months later.
How Safe are Facet Joint Injections?
Fortunately, there are very few risks associated with nerve root block Injection and is considered as safe. Very uncommon risks involve:
1-The injection may not be in the exact spot- this is rare as it is done under x -ray control.
2-Pain returns after an intial response- a repeat injection may resolve the problem.
3-The problem may be too much for an injection to resolve and surgery will be performed to decompress patient’s nerve root.
Follow Up:
There is no fixed time to follow up injection patients but we advise them to allow at least up to two
weeks for their pain to improve. If the pain relief isn’t adequate we will advise you further treatment