Selective Nerve Root Blocks

Irritated nerves can cause significant pain and discomfort. Nerve roots are attached to the spinal cord, and one exits each side of the spine at each vertebrae. These nerves are the communicators in our bodies, carrying signals throughout the body to and from the brain, muscles, and skin. A nerve root can become irritated or compressed from a damaged disc or from contact with a bone spur. Symptoms may include pain, tingling, numbness, or weakness. We have tools to help determine the cause of the pain and also to help alleviate the discomfort.

The area of the body where you are experiencing symptoms points to where the nerves are inflamed. Nerve irritation in the neck (cervical spine) can cause symptoms in the neck, arm or shoulder. Nerve irritation in the upper and mid back (thoracic spine) can produce upper back pain or pain along the ribs and chest wall. Irritation in the lower back (lumbar spine) can produce symptoms in the lower back, hip, buttock, or legs.

One of the tools in our toolbox is the Selective Nerve Root Block (SNRB). These are very similar to Epidural Steroid Injections (ESIs). Like ESIs, the medication used includes a steroid to decrease inflammation and an anesthetic to numb the area. For SNRBs, we administer the injection under the vision of an X-ray machine so we can be sure the injection enters the site exactly where we want it to enter.

ESIs and SNRBs are a little bit different. The purpose of an ESI is to inject medication to treat all the nerve roots in a certain area, while a Selective Nerve Root Block is to numb just one or two spinal nerves. We use SNRBs for two reasons: diagnostic or therapeutic. For the diagnostic block, enough medication is utilized to numb one root to determine if that root is causing the patient’s pain and discomfort. If the pain subsides after the injection, the pain generator is presumed to have been identified. We use a larger volume of the medications to treat the irritated nerve for a therapeutic block.

If you are interested to learn more, please make an appointment to see a Pain Management Specialist at OSC.

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