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The nerve root injection is a procedure where a local anesthetic and steroid solution are administered near the nerve as it exits the spinal canal.  This is done under fluoroscopy (watching under live x-ray) to deliver the drug to the precise location. 

Am I a candidate for a nerve root injection?
At Midwest Pain Treatment Center, the physician examining you in consultation with your referring doctor, will decide whether you are a candidate for nerve root injection.  Usual conditions for which nerve root injections are done would be herniated or bulging disc, sciatica, and degenerative disc disease.  This is not a complete list of the conditions for which injections are done.  Please discuss with your physician for more details.

What are the benefits of a nerve root injection?
Nerve root injections can reduce inflammation of the nerves and provide pain relief.

How long does the procedure take?
The procedure takes approximately 15 minutes.

Where is the procedure performed?
It is done as an outpatient at our surgical suite under fluoroscopy.

How is the procedure performed?
An IV is started and you will receive sedation through the IV to make you comfortable.  A needle is advanced under fluoroscopic guidance at the side opening of the spine where the nerve exits.  Proper position of the needle is confirmed by injecting a special dye.  We will not use dye if the patient is allergic to the dye.  After confirming the needle location, we will inject the local anesthetic and steroid solution. 

I am afraid of needles.  Will I have a lot of pain?
Your physician at Midwest Pain Treatment Center will do everything possible to do the procedure with minimal, if any, pain.  As explained above, you will be given sedation intravenously and numbing medication (local anesthetic) at the site of the needle placement.

Can I be sedated for the procedure?
Yes.  You will be awake but usually very comfortable during the procedure.  On occasion we will need to interact with you.  It is likely that you will have no memory of the actual procedure.  You are required to have a driver remain in the facility before and during the procedure, then drive you home following the procedure.

What can I expect after the procedure?
Immediately after the procedure, you may have relief of your pain.  Sometimes you may feel numbness in your legs or arms, depending upon where the procedure was done.  This is from the local anesthetic that was used during the procedure.  Four to six hours after the local anesthetic wears off, your pain may come back.  Sometimes your pain may even get slightly worse for up to 48 hours.  You may not see full improvement in your symptoms until the 4th or 5th day.

What should I do after the procedure?
After the procedure, you will be required to have someone drive you home.  The next day you should be able to resume your normal daily activities that you were doing prior to the procedure. 

Can I go to work the next day?
If you are working prior to the procedure, you can go back to work the following day.  If you were not working prior to the procedure, due to the pain and other problems, you should discuss this with your physician at Midwest Pain Treatment Center for further instructions.

What are the risks and side effects?
Usually the procedure is safe.  However, with any procedure, there are risks, side effects and complications.  The risks, side effects, and complications vary depending upon where the nerve root injection was done.  Whenever an injection is done through the skin, there is a risk of infection.  To prevent this, we perform the injection under sterile conditions.  In spite of this, you can still develop infections and soreness.  In addition, one may develop more numbness than expected depending upon the spread of the local anesthetic.  One may also develop a headache if there is spinal fluid leakage.  Bleeding in the soft tissues or the spinal canal may occur in rare occasions, especially if you are on anticoagulants (“blood thinner”) or have various rare conditions that affect blood clotting.  Infection or bleeding in the spinal canal may lead to neurological damage. However, all the complications are extremely rare. 

Can you tell me more about the “spinal headache”?
This headache usually develops as a result of spinal fluid leakage from the injection.  It has different symptoms than other types of headaches, such as migraines.  In our experience, the chance of someone developing a headache is less than 1%.  The headache may last anywhere from 5-10 days and may even require an additional procedure called a blood patch. 

How many nerve root injections do I need?
It varies.  It depends upon your response to the first injection.  Upon re-evaluation, this will be decided by the physician at Midwest Pain Treatment Center, along with your referring physician.

How should I prepare for the procedure?