Cervical, Thoracic and Lumbosacral Diagnostic Nerve Root Injections

What is a nerve root and why is a selective nerve root injection helpful?
Nerve roots exit your spinal cord and form nerves that travel into your arms or legs. These nerves allow you to move your arms, chest wall, and legs. Inflammation of these nerve roots may cause pain in your arms or legs. These nerve roots may become inflamed and painful due to irritation, for example, from a damaged disc or a bone spur. A selective nerve root injection provides important information to your physician as to whether the nerve concerned is a significant source of pain. It serves to prove which nerve is causing your pain by placing temporary numbing medicine over the nerve root of concern. If your main pain complaint improves after the injection than that nerve is most likely causing your pain, If your pain remains unchanged, that nerve probably is not the cause of your pain. By confirming or denying your exact source of pain, it provides information allowing for proper treatment, which may include limited surgery at a specific location.

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Here a disc herniation has caused inflammation and pressure on a nerve.

What will happen to me during the procedure?
Next, while lying on a table, the skin over your spine will be well cleaned. The physician will numb a small area of skin with numbing medicine which stings for a few seconds. Next, the physician will use x-ray guidance to direct a very small needle just next to the nerve root without injuring the nerve root. He will then inject contrast dye to confirm that the medicine flows around the nerve root. This may increase your usual pain for about 30 seconds. Lastly, numbing medicine will be injected along the nerve root to hopefully stop your pain, if that nerve is the source of your pain.

What should I do after the procedure?
Your arm or chest wall or leg may temporarily feel numb or weak from the anesthetic for several hours. You will wait 15-30 minutes before going home. No driving for eight hours because you may experience temporary numbness or weakness.

General Pre/Post Instructions
You should eat a light, but not a full meal at least 2 hours before the procedure. If you are an insulin dependent diabetic do not alter your normal food intake. Take your routine medications before the procedure (such as high blood pressure and diabetes medications) except stop aspirin and all anti-inflammatory medications (e.g. Motrin/Ibuprofen, Aleve, Relafen, Daypro) 3 days before the procedure. These medicines may be re-started the day after the procedure. You may take your regular pain medicine as needed before/after the procedure. If you are on coumadin, heparin, lovenex, plavix or ticlid you must notify the office so that the timing of stopping these medications can be explained. If you are on antibiotics please notify our office, we may wait to do the procedure. If you have an active infection or fever we will not do the procedure. You will need to bring a driver with you. You may return to your current level of activities the next day including return to work.