A selective nerve root block (SNRB) is a targeted epidural steroid injection for diagnosing and treating back pain. During the procedure, we inject a small amount of steroid and numbing medication around the nerve roots exiting the spinal cord. This procedure can be done in the neck, upper and lower back. The SNRB allows the doctor to determine exactly what nerve root or roots are being affected.
Patients at Trinity Pain Management may undergo this procedure with or without sedation. During the procedure, a local anesthetic is used to numb your skin. The doctor will then insert a thin needle directly into the epidural space guided by the fluoroscopy machine (a type of x-ray). A dye may also be injected to further ensure that the needle is at the correct spot. During the injection of the steroid and local anesthetic, temporary discomfort along the nerve root may be felt until the local anesthetic sets in which is usually within seconds.
Once the procedure is completed, you will be monitored for up to 30 minutes. Following the procedure, take it easy for the rest of the day. You may feel immediate pain relief and numbness in your back for a limited period of time after the injection. This tells you the medication has reached the right spot. You can usually return to work the next day, but always check with your doctor. Your pain may return after a short pain-free period. This may be caused by the needle irritation or by the corticosteroid itself. Corticosteroids usually take two to seven days to start working.
The relief of symptoms from a selective nerve root block varies among patients but can last several months. The duration of pain relief you experience depends on the pathology of the disc, dura or nerve root you have. If your pain is due to injury of several different regions of the spine, more injections might be needed. Even if the injection offers only short-term relief, it does provide time for the nerve root and dura to heal for long-term pain relief. At this time physical therapy should be done in order to provide long lasting pain relief.