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Selective Nerve Root Block
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Nerve roots are attached to the spine and grow out of each side of the spinal column at every level. They carry signals throughout the body from the skin to the muscles. When irritated, patients may experience pain, numbness, tingling and sometimes weakness down an arm or leg.
In cases where an imaging study (MRI) does not clearly show which nerve is causing the pain, a selective nerve root block injection can be performed to assist in isolating the source of pain.
The injection involves both a steroid (an anti-inflammatory medication) and a numbing agent. If the patient’s pain goes away after the injection, it can be inferred that the source of the back pain is the specific root that has just been injected. Following the injection, the steroid also helps reduce inflammation around the root.
While an epidural steroid injection may produce the same pain relieving effect, a selective block is a more focused injection with greater diagnostic value. When the two techniques are compared, injections of a large amount of steroid throughout the epidural space (epidural injections) are more appropriate when one or two individual nerves cannot be identified as the most likely pain source.
Epidural injections are akin to a "flood" of steroids, covering a wide range of levels but placing only a small amount of steroid at each level.
Selective blocks are more of a "precision guided" approach, with the injection of a relatively large amount of steroid around a specific root. Selective blocks are useful when one or two roots are considered to be the likely cause of the patient's symptoms.
For example, patients with disc herniations can benefit from selective blocks. Since roughly 90% of disc herniations are resolved by the body when given enough time, pain management is important to avoid surgery.
Because the pain related to a herniated disc is caused by inflammation of the nerve root and not directly from the pressure of the disc (which causes numbness but not pain), highly focused steroid injections can reduce inflammation and pain in many patients.
We Can Help
The physicians at the Northwest Surgical Specialists Pain Management Center are board-certified pain management practitioners fluent in diagnosing the need for and performing a full suite of procedures designed to provide long-lasting, effective pain relief.
If you or a loved one is experiencing the ill effects of chronic back and/or leg pain, contact the Pain Management Center at 847.885.9525 to arrange a consultation.
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