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All Posts Tagged: selective nerve root block treatment

2018-07-01 (1)

Are you going through severe back pain? Now NO more!

Resolving a single structure within the spine as the source of pain can prove to be a diagnostic challenge due to the complexity and complication of the structures involved in the spinal column. Additionally, discrete anatomical structures can clinically present with related symptom patterns and no physical examination finding can be specifically ascribed to any one structure. To further complicate this dilemma, multiple structural abnormalities noted on imaging studies are frequently found to be painless.

Selective nerve root blocks are based on the assumption that delivering a small amount of medication to a specific target can precisely point out  the source of pain and provide information that could affect or predict their surgical outcome.  At the Pain Management Institute,  we offer cervical nerve root blocks under fluoroscopy guidance. Dr. Zaki Anwar is very experienced in these procedures and has a very meticulous approach and safety record.

When a nerve root becomes condensed and swollen, it can cause back and/or leg pain. Occasionally, an imaging study (e.g. MRI) may not clearly illustrate which nerve is causing the pain, therefore selective nerve root block injection is performed to assist in separating the source of pain. Adding more to its diagnostic function, this type of injection for pain management can also be used as a treatment for a far lateral disc herniation (a disc that ruptures outside the spinal canal).

The rate of success differs depending on the primary diagnosis and whether or not the injections are being used primarily for diagnosis. Those who are facing the symptoms of  herniated disc, sciatica or swelling or irritation are the appropriate candidates for selective nerve root block. The following patients should not undergo this treatment:

  • If you have an allergy of any medication which is needed to be injected
  • If you use medication for blood thinning for instance (Coumadin injectable Heparin)
  • If you have an infection currently you are suffering from

During a Selective Nerve Root Block, your doctor will target exact condensed or irritated nerves in your neck, upper back, or lower back, injecting an anesthetic, anti-inflammatory corticosteroid or a mixture of these two medications into the space immediately surrounding the nerve or nerves.

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2018-03-08 (1)

Your Pain Stops Here

A selective nerve root block is a slightly surgical procedure that is done to diagnose and treat cervical and lumbar pain and related pain suffering areas. The procedure includes injecting local anesthesia straight into the expected problematic nerve root of the spinal column to help recognize the cause of a patient’s pain also it helps to relieve pain for the shorter period

Symptoms of an irritated nerve root

The spinal pain happens when any of the spinal nerve becomes irritated, inflamed or compressed. The pain may spread in the upper and lower areas depending on the location of the nerves

If a nerve is damaged in the cervical region, the pain and other symptoms will be felt in the neck, shoulder and arms, whereas the nerve irritation in the lower spine causes numbness, tingling in the lower back, hips, buttocks and legs

Sometimes it becomes difficult for a physician to identify the exact nerve causing pain, at times MRI may not indicate the problematic nerve. In such condition a selective nerve root block is recommended to restrict the nerve root that is the source of pain

How a selective nerve root block is performed

A selective nerve block involves injecting a local anesthetic formulated with Corticosteroid to the targeted nerve root. The local anesthesia numbs the nerve sensation, while the steroids help in decreasing inflammation and the pain arising

The selective nerve root blocks are much the same as the epidural injections, however the medications are administered in the pain causing nerve root and not in the epidural space. The selective nerve root block results may vary from person to person as some nerve roots are difficult to reach and administer

What to expect after the procedure?

Many patients undergoing selective nerve root block can resume their routinely activities following the procedure. Some patients may report a sudden relief from the symptoms that is because of the numbness. The pain may reappear until the steroid shots initiate its effects. The relief of pain symptoms from a selective nerve root block depends on the levels of your pain and lasts from several days to several months

What will happen following the procedure?

Soon after a selective nerve root block, patients may experience incremental pain at the site of injection, pain while movement, lightheadedness, nausea, headache and vomiting all these symptoms will last in a day

Risks and complications

Risks related to selective nerve root block are very rare, including, infection, bleeding and allergic reactions with the medications applied during the procedure. Very rare and serious complications include, nerve damage and paralysis

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Selective nerve root block for diagnosis and back pain management


A selective nerve root block is a slightest invasive procedure that is done for the diagnosis and treatment of cervical pain, thoracic and the lumbar pain and other pain associated with the spine

The procedure involves injecting a local anesthesia directly into a certain targeted nerve of the vertebral column to help indicate the source of patient’s pain causes

When a spinal nerve root become inflamed or pinched it can cause back pain, additionally the, symptom might be felt in the upper or the lower area of the spinal cord

For instance;

  • Cervical spine nerve inflammation may bring pain, numbness and weakness in the neck shoulder and arms
  • Where as the thoracic nerve pinching can cause inflammation in the upper back and the lower back along with the chest wall and the ribs
  • The lumbar nerve root can cause pain and weakness in the lower back, hips, buttock and the legs
  • In some cases the source of patient’s pain cannot be identified even the physical examination and imaging may not be as helpful to identify which nerve is causing pain

The purpose of selective nerve root block is to disengage the nerve root that is the cause of discomfort to the patient, moreover the selective nerve root serves as the remedy to comfort various painful conditions

The Selective nerve root block is carried by injecting a local anesthetic along with steroids in the targeted nerve root. The local anesthetic numbs the nerve and the steroid helps to reduce swelling and discomfort, the medications are specifically directed at the nerve root.

The results of selective nerve root block may vary case to case as some nerve roots are very complex to treat due to their location and surrounding conditions

Conditions that are treated with selective nerve root blocks

The conditions that are commonly well treated with selective nerve root blocks include

  • Cervical pain
  • Lumbar nerve root pain
  • Failed back surgery syndrome
  • Shrinking of the spinal canal
  • Bulging intervertebral disc
  • Herniated disc
  • Arthritis


A selective nerve root block is less invasive therapy that can potentially diagnose and treat many symptoms that result from spinal nerve root inflammation. These procedures are considered safe and beneficial therapy for several chronic pain conditions

The desired results can be observed within days to months, the selective nerve root therapy can be repeated if required

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