Nerve Root Injection (Nerve Root Block)
Sciatica & Disc Herniation Treatment
What is a nerve root injection (or nerve root block)?
A nerve root injection is a very common procedure where a mixture of local anaesthetic and steroid (anti-inflammatory) is injected around a swollen or compressed spinal nerve, to help relieve the pain and inflammation of nerve pain.
Nerve pain and inflammation is most commonly due to compression from a disc herniation (disc prolapse) or stenosis. This is typically due to disc degeneration, or “wear and tear,” in the spine. Nerve root injections, also known as nerveblocks, are commonly performed in the lower back, or lumbar spine, to treat radiating leg pain, known as sciatica. Nerve root injections can also be performed in the neck (cervical spine) to treat symptoms of arm pain (brachialgia) or cervical radiculopathy.
If sciatica pain or nerve pain cannot be controlled with pain medications then a trial of a nerve root injection (steroid injection) is a very appropriate and highly recommended treatment option. It is a very safe procedure that may help improve painful symptoms. The procedure is typically performed under CT guidance by a radiologist, or by a pain physician under sedation with the aid of an x-ray.
Why does Dr Oehme recommend a nerve root injection?
In the cascade of treatment for sciatica and other nerve root compressive problems, such as radiculopathy, following failure of medications to control the pain, a nerve root injection is a safe and simple treatment that may help relieve the symptoms of nerve pain. The injection of local anaesthetic and steroid reduces the inflammation in the nerve to help with pain. In most patients with disc prolapse it is worthwhile trying a nerve root injection prior to consideration for surgery. If the nerve root injection helps control the pain, surgery may be avoided or delayed. In addition, if the nerve root injection does help, it is diagnostic that the compressed nerve is the symptomatic level, and is predictive of a good surgical response. |
Lumbar Nerve Root Injection Video (Transforaminal Epidural)
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What happens during a nerve root injection?
Most nerve root injections are performed by a radiologist under CT guidance. These are routinely performed at most radiology facilities.
The patient lays face down on the CT scanner table. The procedure is performed as a sterile procedure to reduce the chance of infection. A small amount of local anaesthetic is injected into the skin so that the needle passes through without causing any pain. A radiologist who specialises in the procedure performs the injection.
A needle is advanced under CT guidance around the compressed nerve root. Once the position of the needle is confirmed with CT, a small mixture of local anaesthetic and steroid is injected around the nerve. The local anaesthetic numbs the nerve whilst the steroid reduces inflammation. The needle is removed following the injection and the patient is able to mobilise.
Dr Oehme will advise if a nerve root injection is appropriate for you at your consultation. His rooms will also book the procedure at an experienced radiology facility. For more information about lumbar nerve root injections watch the video above. For more information about cervical nerve root injections watch the video below.
What happens during a nerve root injection?
Most nerve root injections are performed by a radiologist under CT guidance. These are routinely performed at most radiology facilities.
The patient lays face down on the CT scanner table. The procedure is performed as a sterile procedure to reduce the chance of infection. A small amount of local anaesthetic is injected into the skin so that the needle passes through without causing any pain. A radiologist who specialises in the procedure performs the injection.
A needle is advanced under CT guidance around the compressed nerve root. Once the position of the needle is confirmed with CT, a small mixture of local anaesthetic and steroid is injected around the nerve. The local anaesthetic numbs the nerve whilst the steroid reduces inflammation. The needle is removed following the injection and the patient is able to mobilise.
Dr Oehme will advise if a nerve root injection is appropriate for you at your consultation. His rooms will also book the procedure at an experienced radiology facility. For more information about lumbar nerve root injections watch the video above. For more information about cervical nerve root injections watch the video below.
Cervical Nerve Root Injection Video (Transforaminal Epidural)
What are the risks of having a nerve root injection?
Most nerve root injections are performed very safely and most patients have minimal side effects. The most common complication is to have some discomfort around where the needle passes. This usually resolves over the course of a day or so.
Often the nerve pain will disappear almost immediately after the injection, if it has been successful. Sometimes, however, it does take a couple of days for the inflammation in the nerve to subside. In a small percentage of patients the injection may have no clinical benefit. Although this is frustrating for patients, it is helpful information for the surgeon as it may indicate the nerve pain is due to another cause or another spinal level.
It is common to get tingling in the distribution of the nerve following the injection. Other rare complications including infection, bleeding, bleeding causing haematoma requiring surgery, or rarely, neurological injury.
What factors may prevent me from having this procedure?
Factors which may preclude you from having a nerve root injection include:
1. If you are taking blood thinning medications such as aspirin, Plavix or Warfarin.
2. If you have allergy to contrast material.
3. Abnormal spinal anatomy
4. Morbid obesity
What happens after the procedure?
Patients are usually asked that someone else will drive them home from the injection. You are able to walk almost immediately after the procedure. It is also advisable that you should not perform any strenuous exercise for a period of one to two days after the injection.
How long do nerve root injections provide symptom relief?
The response of patients to nerve root injections is variable. A small percentage of patients will have no benefit from the procedure. Most patients will have benefit that lasts somewhere between two weeks and two months. Some patients will get longer lasting relief from the procedure.
If pain returns, one option is to have another nerve root injection. The second option is to consider surgery to decompress the nerve. If you have any doubt, Dr Oehme will advise you if having a nerve root injection is an appropriate treatment.
Who performs nerve root injections?
Nerve root injections can be performed in both the lumbar spine, and also in the cervical and thoracic spines. Dr Oehme will recommend injections to many patients prior to consideration for surgery to see if it settles nerve pain. Dr Oehme does not perform the procedures himself, but will refer you to either a specialist radiologist who performs the procedure under CT guidance, or to a pain physician who performs the injection under sedation with x-ray guidance.
Dr Oehme will advise if nerve root injection is appropriate for your spinal condition. For more information or to arrange a time to discuss surgery with Dr Oehme contact Keyhole Neurosurgery on 1800 DO SPINE (1800 367 746).
What are the risks of having a nerve root injection?
Most nerve root injections are performed very safely and most patients have minimal side effects. The most common complication is to have some discomfort around where the needle passes. This usually resolves over the course of a day or so.
Often the nerve pain will disappear almost immediately after the injection, if it has been successful. Sometimes, however, it does take a couple of days for the inflammation in the nerve to subside. In a small percentage of patients the injection may have no clinical benefit. Although this is frustrating for patients, it is helpful information for the surgeon as it may indicate the nerve pain is due to another cause or another spinal level.
It is common to get tingling in the distribution of the nerve following the injection. Other rare complications including infection, bleeding, bleeding causing haematoma requiring surgery, or rarely, neurological injury.
What factors may prevent me from having this procedure?
Factors which may preclude you from having a nerve root injection include:
1. If you are taking blood thinning medications such as aspirin, Plavix or Warfarin.
2. If you have allergy to contrast material.
3. Abnormal spinal anatomy
4. Morbid obesity
What happens after the procedure?
Patients are usually asked that someone else will drive them home from the injection. You are able to walk almost immediately after the procedure. It is also advisable that you should not perform any strenuous exercise for a period of one to two days after the injection.
How long do nerve root injections provide symptom relief?
The response of patients to nerve root injections is variable. A small percentage of patients will have no benefit from the procedure. Most patients will have benefit that lasts somewhere between two weeks and two months. Some patients will get longer lasting relief from the procedure.
If pain returns, one option is to have another nerve root injection. The second option is to consider surgery to decompress the nerve. If you have any doubt, Dr Oehme will advise you if having a nerve root injection is an appropriate treatment.
Who performs nerve root injections?
Nerve root injections can be performed in both the lumbar spine, and also in the cervical and thoracic spines. Dr Oehme will recommend injections to many patients prior to consideration for surgery to see if it settles nerve pain. Dr Oehme does not perform the procedures himself, but will refer you to either a specialist radiologist who performs the procedure under CT guidance, or to a pain physician who performs the injection under sedation with x-ray guidance.
Dr Oehme will advise if nerve root injection is appropriate for your spinal condition. For more information or to arrange a time to discuss surgery with Dr Oehme contact Keyhole Neurosurgery on 1800 DO SPINE (1800 367 746).