Spinal nerve root block injection

What are spinal nerves?

The spine is made up of a column of 26 bones (vertebrae) sitting one on top of the other. At the top is the skull and at the bottom is the pelvis. Between each vertebra and the next are pairs of spinal nerves. These carry sensation and movement messages to different parts of the body. Irritation of the nerve can create pain in the spine and the relevant body area.

What is a nerve root block injection?

A small amount of local anaesthetic and steroid is injected onto 1 or more of the affected nerves.

Where is it done?

The procedure is carried out in either a day case clinical area or in an outpatient area. An appointment will be sent to you by the pain clinic secretaries stating the location for the injection.

On arrival

• You may be asked to put on a gown.
• You will be asked to lie on your stomach on the X-ray table.
• The area is cleaned with antiseptic.
• X-ray images are taken throughout this procedure to direct the needle to exactly the right place.
• The consultant will numb the area with a local anaesthetic before putting in the nerve injection.
• You may experience some mild discomfort, although this is short lived.

Can I take my usual tablets?

Take your usual medications in the morning and bring your medications with you. Patients taking anticoagulants (blood thinning drugs) such as warfarin or clopidogrel, or diabetics taking medication will be given individual information. Please telephone the Pain Clinic nurse if you need advice.

Eating and drinking

You may eat and drink as normal, unless your pain consultant advises otherwise.

How long will I be in hospital?

Although the procedure itself takes 15 to 20 minutes, you will be given a time to come in for either a morning or afternoon procedure. Due to the way the theatre lists are organized, you may have a substantial wait before your injections are done, so please come prepared for this.

After the procedure, you will be offered a drink and a biscuit and allowed home shortly afterwards.

Driving home?

For safety reasons you are asked not to drive on the day of your procedure. It is preferable that you have someone with you for the rest of the day.

At home

Your leg may be weak for a few hours. You may move around freely at home unless you have been advised to the contrary by a member of staff. You do not need to do any specific back exercises unless you have been instructed to do so.

Risks

• You may have discomfort at the site of the injection, which should last no longer than 48 hours. In a third of patients the injections can make your symptoms worse for about a week.
• Very rarely people can be allergic to the injection, resulting in redness and itching. This is not serious, but we need to know for future treatments.
• There are no serious complications to this procedure, but if problems arise please consult your GP who will contact the Pain Clinic if necessary.
• Unfortunately, no injection is without risk. In a very small number of patients, there is a risk of damage to tissues in the area of the injection and, very rarely, a permanent increase in pain.

Will it work?

Nerve route block injections can be very effective but do not work for everyone. They are easily performed and worth trying.

What happens next?

About 6 weeks after your procedure, you will either be asked to telephone our medical secretaries to give a progress report, or your pain consultant will give you a form to post back to us. Either way, the next step in your treatment will be decided according to the amount of benefit you have had from the injections.

If your pain has improved significantly, you will not need a routine follow up appointment. Instead, you will be given a patient initiated follow up which is valid for a year, unless otherwise stated. During this time, you can contact us should the same pain become difficult to manage again. Unfortunately, you cannot request a further appointment to discuss any pain that we have not already assessed.

Contact

For injection treatment follow up please contact your consultant’s secretary, Monday to Friday between 8:00 am and 4:00 pm.

To rearrange an outpatient appointment, contact the Booking Office on 0300 422 5327

Dr Young’s secretary

Tel: 0300 422 3383

Dr Makins secretary

Tel: 0300 422 2558

Dr Harper’s secretary

Tel: 0300 422 3383

Dr Bodycombe’s secretary

Tel: 0300 422 3198

Dr Rea’s secretary

Tel: 0300 422 2804

Dr Patel’s secretary

Tel: 0300 422 2558

For all other queries please contact the:

Clinical Nurse Specialists

Tel: 0300 422 2976

An answerphone will be in operation at all times, please leave a message and we will return your call as soon as possible.