Transforaminal Epidural Nerve Root Injection also known as a Dorsal Root Ganglion Block
It is an injection with local anaesthetic (and sometimes with corticosteroid) next to a specific nerve root. Along the spine, there are several “holes” (foramen) through which nerve roots come out. If these holes are partially closed or compromised by disc protrusions, osteophytes, poor alignment of the vertebrae (lysthesis), etc., the nerve root can be pinched or compressed, causing irritation and inflammation that typically produces pain that radiates long that the nerve root.
Why is nerve root injection performed?
When the nerves are irritated or compressed by a protruding disc, a narrowing of the canal or other causes, the resulting inflammation can cause pain, numbness and tingling. The local anaesthetic/corticosteroid can reduce pain and other symptoms that can provide diagnostic information to your doctor.
The actual injection takes only a few minutes. The procedure usually lasts 45-60 min. The injection consists of local anaesthetic and corticosteroid.
The nerve root injection procedure
All our procedures begin with the injection of local anaesthetic through a very small needle. It feels like a small prick followed by burning. When the skin is numb, another needle is used for the procedure that feels like a little pressure at the injection site. If you experience pain during the procedure, the doctor will inject more local anaesthetic, as needed. We also perform the injection using sedation with an anaesthetist so that no pain is felt whatsoever during the procedure. When injecting the medication next to the root you may notice a cramping sensation for a few seconds.
Sedation can be administered. You can choose if you prefer, that the procedure is performed only with local anaesthesia. You can also choose to have intravenous sedation. Sedation is not general anaesthesia, this means that you may notice that we are doing the procedure, although it prevents it from being unpleasant.
It is performed in the operating room with the patient face down for back and face up injections for neck injections. Vital signs are monitored. In addition to your doctor and the x-ray technician, there will be a nurse in the operating room at all times. The skin is cleaned with an antiseptic solution and then the procedure is performed.
After the procedure
Immediately after the injection, you may feel the affected leg or arm a little heavy, numb, or numb. This is due to the effect of the local anaesthetic and lasts only for a few hours. After the effect of the local anaesthetic passes, the pain may return within a few hours and it may even hurt at the injection site for 2-3 days. The effect of the blockade normally begins at 2-3 days.
We recommend that patients take a rest on the day of the procedure. The next day you can live a normal life, except activities that require effort or exercise.
Many times you get immediate pain relief, due to the effect of the local anaesthetic injected. This disappears in a few hours and then the improvement is obtained by the anti-inflammatory effect of the administered corticosteroid, which can last from a few days to several months.
At the London Spine Unit, we have some of the best specialists to perform nerve root injections. Book an appointment to get a checkup.
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How long does it take to get pain relief?
Many times you get immediate pain relief, due to the effect of the local anaesthetic injected. This disappears in a few hours and then the improvement is obtained by the anti-inflammatory effect of the administered corticosteroid, which can last from a few days to several months.