Transforaminal nerve root block

A transforaminal nerve root block is a procedure used to treat neck and back pain and can also be used to diagnose the specific source of nerve pain. The nerve root may become inflamed due to irritation from disc herniation or rupture, arthritis or spinal stenosis (narrowing of the spinal canal). It involves injecting anti-inflammatory (steroid) medication near the nerve root as it exits the spinal column. Complications are rare, but can include pain, blood pressure changes, infection, bleeding and temporary increase in pain levels. Depending on the location of the procedure and your response, you may require a ride home. Many patients experience pain relief for several months and some may even have permanent pain relief.

When you arrive, a nurse will obtain a description of your pain and how you are managing daily activities. Your blood pressure, pulse, temperature and weight will be recorded. Medications, allergies and a brief health history will be reviewed. It is important to let the nurse know if you have allergies to X-ray dye, Betadine or latex, if you are taking blood thinners, such as Coumadin, Plavix, Pradaxa or Lovenox, if you have diabetes or if you might be pregnant.

After discussing treatment with your physician and signing procedural consent, you will go to the X-ray room where you will be helped onto the X-ray table into the best position for visualizing your spine. We will try to make you as comfortable as possible. Your skin will be cleansed with antiseptic and after numbing the skin with local anesthetic, the physician will place a small needle near the nerve using fluoroscopic guidance. A small amount of contrast dye may be injected to confirm the proper placement of the needle and the steroid will be injected. The entire procedure will take less than a couple of minutes.

The anesthetic can make your arms legs feel weak or numb so plan to stay with us for about 15 to 20 minutes after your procedure. A nurse will be available to answer any questions you might have and to review discharge instructions and follow-up care.

When you go home

• Activity: Rest and avoid activities that might aggravate your pain. You can usually return to work that day and resume exercising the next day if you do not experience discomfort.
• Pain: Ice will help with localized discomfort from the injections for the first 48 hours, as will taking your normal pain medication. Most people will notice an improvement in three to seven days.
• Follow-up: You may be asked to follow-up with your physician or to repeat the injection in two to three weeks.