A selective nerve root injection is a therapeutic and diagnostic tool that helps physicians determine the cause of a patient’s back pain. Nerves along the spine can become damaged or irritated from a bulging disc, bone spur, or narrowing of the spinal canal. If any of these conditions develop, patients may experience inflammation, numbness, radiating pain, and tingling in the spine. A selective nerve root injection contains a local anesthetic that reduces a patient’s pain and provides physicians at Orthopedic and Wellness with diagnostic information. Should this treatment provide a patient with adequate pain relief, a complementary procedure called radiofrequency ablation may be considered afterward. Similar to other injection therapies, a selective nerve root injection is done using fluoroscopy guidance (x-ray imaging) to identify the exact nerve causing pain. While the injection only takes a few minutes to complete, the procedure may last an hour.
Patients may be given intravenous sedation to help them relax during the procedure. Patients will not be asleep when the selective nerve root injection is performed because they must be able to communicate with the physician during the procedure. An Orthopedic and Wellness physician may inject a contrast dye into the area being treated to outline the path of the nerve, which helps confirm proper needle placement. The patient will lie down on an x-ray table with a pillow under their abdomen. Shortly thereafter, the physician will use a local anesthetic to numb the skin before the procedure needle is inserted. When the procedure needle is placed near the inflamed nerve, the patient may briefly feel radiating pain in the spine. This is normal and tells the physician that damaged nerve roots are in the targeted location. Once proper needle placement is determined, another local anesthetic and a steroid medication mixture will be injected into the nerve root. The nerve will become numb, and the affected limb may also feel numb or tingly. After the affected nerve roots have been treated, the needle will be removed and a bandage will be placed over the injection site.
Following the selective nerve root injection, the patient is taken into a separate room to recover. After an hour or two, he or she will be able to return home as long as a family member or friend is there to drive them. When the local anesthetic wears off, the pain may return and increase for up to 24 hours. The steroid that is injected usually takes 3 – 7 days to reduce inflammation and pain in the affected nerve roots. The physicians at Orthopedic and Wellness may advise the patient to rest for a day or two before resuming normal, daily activities. If a patient begins to experience redness, itchiness, inflammation, or signs of infection at the injection site, he or she should call Orthopedic and Wellness immediately.