How Do Selective Nerve Blocks Work?

When the nerves in your spine are irritated or “pinched” by a bulging disk or a bone spur, it can lead to inflammation that causes pain, numbness, or tingling. One way to quell that pain is with a selective nerve block. It’s an injection of a local anesthetic and steroid medication along a specific nerve root. Selective Nerve Blocks are also used to pinpoint and diagnose a problem that MRI or other diagnostic testing failed to do.

There are several foramina (or “holes) along the spine from which nerve roots emerge. If these spaces are partially closed due to a bulging disk or misalignment of vertebrae, the nerve root can also be compressed, resulting in shooting pain along the nerve root.

With a selective nerve root block, a local anesthetic and steroid medication is injected with a small needle into the opening alongside the nerve root. All you feel is a little pinch and a slight burning sensation as the anesthetic begins to work. Once the skin is numb, you only feel a bit of pressure from the procedure needle at the injection site.

While the injection itself only takes a few minutes, the procedure may take up to an hour. During that time, the skin on your back or neck will be cleaned with an antiseptic solution, you will be positioned in the procedure suite, and observed by a nurse after the procedure.

The procedure is typically performed while you are lying on your stomach for a back injection or on your side for a neck injection.  If you feel any pain during the process, the physician will inject more local anesthetic. However, the placement of the needle is not painful. During injection of the local anesthetic, you may experience a temporary throbbing along the nerve root until the anesthetic takes effect, which is normal.

Right after the injection, you may notice that your pain is gone or greatly diminished. However, that is just the effect of the local anesthetic, which will last for up to 6 hours. Most likely, your pain will return temporarily, and you could have some soreness at the injection site lasting a day or two. The long-term effects of the injection are very positive however, with patients experiencing relief for many months at a time.

It’s best to take it easy after a selective nerve block, applying ice to the site to reduce any pain or swelling. Nevertheless, unless the procedure was complicated, you should be able to return to work the same or the next day.

As with any procedure, selective nerve blocks have some risks and side effects, such as increased pain from the injection (which is usually temporary), the possibility of headaches, infection, bleeding or nerve damage, although these are rare.

If you are on blood-thinning medication, have an active infection, or are allergic to any of the medications being injected, you should not have a selective nerve root block. If you are on blood-thinning medication, your doctor may advise you to stop taking the medication for four to seven days before receiving an injection. Likewise, anti-platelet drugs (e.g. Plavix) may need to be stopped for up to 10 days prior to the procedure.

If you live in the Plano, Texas area and are experiencing neck or back pain, Tarpon Orthopedics can help you regain the ability to move pain-free again. We are experts in pain management and selective nerve blocks. Call (972) 596-1059 for a consultation today in our West Plano, North Plano, or Addison, Texas locations.

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