Selective Nerve Root Block - Mainland Pain Management

If you suffer from pinched or inflamed nerves (sometimes referred to as sciatica), nerve block, selective nerve root block, or transforaminal epidural steroid injection may be an option for treatment. Typically, a numbing medication like lidocaine is injected with or without steroids into the inflamed nerve. Diagnostic Selective Nerve Root Block, i.e., SNRB, involves injecting only the numbing medication. The steroids are used for therapeutic SNRB.

Nerves exit the spinal column via the intervertebral foramen, an opening between the spinal bones. Steroids injected in this manner directly decrease the inflammation around the pinched nerve. The procedure is a quick outpatient procedure in which an X-ray machine is used to identify the location of the pinched nerve. It can be done with no or minimal sedation. We at Mainland Pain Management provide effective selective nerve root block treatment in New Jersey for pain management.

Why Do I Need a Selective Nerve Root Block?

SNRB is a quick, minimally invasive way to administer steroids around inflamed nerves if you are suffering from sharp, shooting pain radiating to arms or legs. SNRBs can be done for both legs at the same time. If you were diagnosed with disc herniation or arthritis, you might have a narrowing of the space around the spinal cord and nerves. This pinching can cause inflammation and swelling around the nerve. Steroids work by reducing swelling and inflammation. The pain is usually described as intense pressure, pinching, vice-like, shooting, sharp, stabbing.

Common indications of Selective Nerve Root Blocks are

Herniated discs could be bulges, protrusions, or extrusion
Slipped vertebrae or spondylolisthesis
Bone spurs
Scarring around the nerves after spine surgeries
Joint cysts or facet cysts
Thickening of ligaments around the spinal cord as seen in aging

What are the Risks of SNRB Injections?

The risks are low since the SNRB injections are always done under the continuous guidance of an X-ray machine. However, some of the reported side effects are

Procedural pain and discomfort
Bruising on the skin and swelling
Steroids can cause flushing, a feeling of warmth around the face and chest.
Headaches usually last 24-48 hours
Sleeping problems
Anxiety
Menstrual issues
Water retention
In rare cases, worsening of pain for 1-2 days

Serious complications of SNB injections are rare but can include

Allergic reactions
Infection
Bleeding /Hematoma
Nerve damage
Paralysis

To avoid side effects getting treated by a skilled pain management specialist is a must. One can get the best selective nerve root block treatment in Linwood at Mainland Pain Management.

What Can I Do Before I Opt for SNRB?

Like all pain management interventional options, it is always advisable to try conservative measures before getting SNRB, i.e., Spinal Nerve Root Block injection. Some of the conservative measures include and are not limited to

Over-the-counter inflammatory medications like Motrin and Aleve (make sure you are not on blood thinners and do not have kidney problems or allergies to NSAIDs)
Physical therapy or aquatic therapy
Chiropractor
Nerve pain medications like Gabapentin, Cymbalta, Lyrica
Exercising

Is There Any Testing Required Before SNRB?

It is not recommended that anyone be scheduled for SNRB before relevant imaging. Initial imaging usually includes X-rays. Based on the X-ray results, clinicians usually decide about additional imaging required. The subsequent tests may include MRI and CT scans.
Let your pain team know if you have pacemakers, defibrillators, or spinal cord stimulators. If you are claustrophobic, you may be able to get an open MRI.
If you are taking blood thinners or anticoagulants such as aspirin, Plavix, warfarin, eliquis, or Xarelto, you may need blood tests before SNRB.

The pain team will also contact the prescribing team to ensure that blood thinners are safe to take before the procedures. The pain management team will not be able to proceed if the prescribing physician advises against taking anticoagulants for a recommended period of time.

Before scheduling the procedure, ensure you provide the pain team with the most updated list of medications and allergies. If you take weight loss medications, you might be told to hold them for two days before the procedure. This will help us provide the best selective nerve root block treatment in Linwood.

How Do I Get Ready for SNRB Injections?

Tips for getting ready for Spinal Nerve Root Block injections:

Limit eating or drinking for a certain amount of time before your procedure.
You will be asked to stop anticoagulants or blood thinners before the procedure. The time to stop will depend on the blood thinner you are prescribed. Our specialized pain team will guide you on when to stop the blood thinner.
If you are choosing to get sedatives or anesthesia for your procedures, you will be asked to bring someone to drive you.
If you choose to get anesthesia for the procedure, you will be told to be NPO at least 8 hours before the procedure.
Give yourself ample time to reach the facility, and be prepared to wait at least an hour.
You should have a driver on the day of the procedure.

What Happens During the Procedure?

The Spinal Nerve Root Block Treatment in New Jersey involves the following steps:

You will be asked to change into a gown.
If you have chosen to get sedation for the procedure, you will need an intravenous line before the procedure.
You do not require any antibiotics for the procedure.
The procedure itself is only 5-10 minutes.
You will be asked to lie on a table on your abdomen.
The monitors, including blood pressure and EKG, will then be applied.
The back or neck will be cleaned with a cold cleaning solution.
The area of the approach will be identified with an X-ray machine.
The skin will be numbed with numbing medicine.
The needle is then directed to the appropriate space under the guidance of an X-ray machine.

Transforaminal: Foramina are the openings through which your nerves exit the spinal canal. This approach makes isolating a specific nerve in the spine that is causing you pain possible. Many times, it can alleviate the pain that originates from disc herniation and shoots to your legs. It can also be used to delineate if surgery at one level is indicated for you, especially in cases where the cause of pain is unclear.

The needle is confirmed to be in the appropriate space using a contrast.
Then, a combination of steroids and numbing medication is given.
After the procedure, your back will be cleaned again, and you will be taken to the recovery area.
You may be in the recovery area for 20 minutes to 60 minutes.

How painful is SNRB, i.e., Spinal Nerve Root Block injection?

You may feel a little pinch when the clinician injects numbing medicine, and then you may or may not feel:

Pressure
Tingling
Burning
Momentary pain

What are the Side Effects of Spinal Nerve Root Block injection (SNRB)?

You may experience mild discomfort for 2-3 days at the injection site.
If you have Hypertension or diabetes, you may see a transient rise in blood pressure or blood sugar. This is usually transient and may last up to 48 hours after the injections.
Steroids can cause an increase in eye pressure for patients who have glaucoma.
You may feel transient flushing, anxiety, and sleep disturbance after the injections.

After How Long Before It Shows Effect?

The numbing medicine will help you immediately; however, it will wear off in about 4 hours. Steroids can take up to 7-10 days for full effect.

What are the Risks and Possible Complications of SNRB (Spinal Nerve Root Block injection)?

The risk of complications is very low in the hands of experienced clinicians and with modern equipment like X-ray machines.

However, reported side effects or complications include

Low blood pressure
Headaches
Infection
Bleeding
Hot flashes
Nerve damage
Loss of Bowel or bladder control (urine leakage)
Weakening of bones

What can you Expect After a Spinal Nerve Root Block injection (SNRB)?

The effect depends on the type of procedure you had. Diagnostic blocks are typically done without steroids, so the transient effect may be 4-6 hours. Therapeutic SNRP with particulate steroids can last up to 6 months to 1 year. Some people may have no relief. Sometimes, repeat injections are recommended to increase the chances of the steroid working. You may require additional injections as a top-up to help you with continued pain relief.

Studies have revealed that SNRB can provide reliable pain relief for up to 6 months in many cases. However, every person experiences pain differently, so your experience may vary.

SNRB is most successful at providing temporary pain relief for radicular pain (which is pain shooting down your leg, arms, or chest wall) caused by a lumbar herniated disk and lumbar spinal stenosis. It’s important to remember that these blocks are not intended to cure back pain; their main goal is to provide pain relief. They are recommended as an adjunct to other measures of treatment, including, but not limited to, physical therapy and chiropractic therapy.

When Should I Call the Pain Management Office?

You will be instructed to make a follow-up appointment in 2 weeks. It is highly recommended that you follow up with the pain management specialist regardless of whether the SNRB helped, as further courses of treatment will be discussed in the follow-up visit. For chronic pain, consult for the best pain relief with a spinal nerve root block treatment in New Jersey at our advanced pain management center.

It is recommended to call the office immediately if you are

Feeling dizzy
Have uncontrolled pain that is not helped by Motrin, Tylenol, or ice packs
You are experiencing a fever
If you have increased weakness in your legs or arms
Complete loss of bowel or bladder control

For chronic pain management and effective selective nerve root block treatment in Linwood, consult Mainland Pain Management. Here you will get the best pain relief with spinal nerve root block treatment. Also, learn about the cost of spinal nerve root block injections.