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What are Selective Nerve Root Injections for Pinched Nerves?
A selective nerve root injection, also called a selective nerve root block, is a procedure where a particular nerve root is injected with a local anesthetic and a steroid. The purpose of this procedure is to block the conduction of electrical impulses along and nerve that is being irritated by surrounding structures.
Who needs Selective Nerve Root Injections for Pinched Nerves?
Within the spinal bones are small holes through which the nerve fibers emerge from the spinal cord. Sometimes, the intervertebral discs, which are the soft cartilage between the spinal bones, can protrude out and compress the nerves as they passed through these holes. This compression of the nerve is called a pinched nerve root. As a result of this compression, the nerve fibers get inflamed and the patient experiences symptoms such as numbness, tingling and pain in the areas where the nerve supply is.
What are the steps in Selective Nerve Root Injections for Pinched Nerves?
Identifying the Nerve Root
The procedure is fairly straightforward and involves identifying the nerve root that is causing the pain and injecting it went a small quantity of local anesthetic along with the steroid. The procedure takes a few minutes to perform and only causes mild discomfort which is due to the injection. Most cases are performed by administering a small amount of local anesthetic into the skin, though some patients may prefer sedation instead.
Locating the Injection Site
The procedure is performed with the patient lying on their chest if the back needs to be accessed or lying on their side if the neck needs to be accessed. The exact site to be injected is located using the guidance of a CT scan image. During the procedure, it is not uncommon for the patient to feel a shooting pain along the course of the nerve, especially if the needle touches the nerve when the local anesthetic is being injected. This only lasts a few seconds and this appears shortly after the injection is complete.
Following the procedure, the patient is observed for a short period of time and then discharged home. The patient is advised not to stress themselves for the next day or two and following that can resume normal daily activities.
The risks if any are very few. Patients may experience persistent pain following the procedure but this usually passes after sometime by itself. Allergic reactions are rare as are infections. Nerve damage is also rare.
The procedure is ideally avoided in patients who are taking blood thinning medication such as Warfarin. Any active infections that the patient may be suffering from need to be treated first with a full course of antibiotics. On very rare occasions, the needle with the anesthetic may be passed into the spinal cord and the anesthetic injected into the spinal fluid. This can cause headache and is usually treated with just a period of observation and rest.