Selective Nerve Root Block

A selective nerve root block (also known as a transforaminal epidural injection) is an injection immediately adjacent to a spinal nerve, which your doctor has identified as a possible cause for your symptoms due to irritation or compression. Under X-ray guidance, we will perform a targeted injection of local anesthetic (freezing) and cortisone (steroid) medications into the tissues surrounding the identified nerve. If this nerve is responsible for your symptoms, this injection is expected to diminish inflammation and provide some relief of your symptoms.

HOW DO I PREPARE FOR MY EXAM?

  • Wear comfortable clothing
  • You must have a driver accompany you to this appointment.
  • You must have had an MRI or CT within the past 24 months.
  • If you’ve had recent surgery, but not updated your images, please inform the booking coordinator prior to injection
  • It is important to be off ALL blood thinners prior to injection. If this is not an option, please hold off on the procedure and consult with your doctor.
  • If you have diabetes, please eat one hour before your appointment.
  • Please arrive 15 minutes prior to your appointment.

WHAT HAPPENS DURING MY EXAM?

  • We will provide you with a comfortable clinic gown to change into.
  • A technologist will go over your consent form, explain the procedure, and answer your questions before escorting you to the treatment suite where you will be greeted by the radiologist.
  • The radiologist will clean the skin and inject a local anesthetic, similar to the freezing you would get at the dentist.
  • The needle is then positioned under X-ray guidance, which allows highly accurate placement in the body. To double-check the location, a short-acting anesthetic is injected followed by brief neurologic testing. Once proper needle position is confirmed, the steroid medication is then injected.
  • It is possible you will feel mild, transient discomfort or pressure similar to your usual back symptoms as the medicine is injected. This is short lived and resolves once the anesthetic takes effect.
  • A Band-Aid will be placed at the injection site; then you will be transferred to a wheelchair and brought into another room.
  • After 15 minutes, you will be checked for the expected injection response. If you are able to stand and walk safely, you will be free to leave with your driver.

POST-EXAM INSTRUCTIONS

  • Avoid strenuous activities for 3-5 days.
  • For safety reasons related to the anesthetic, no driving for 24 hours after your exam.
  • Leave on the Band-Aid and don't shower for 24 hours after the exam; avoid tubs and pools for at least 48 hours.
  • A mild increase in blood sugar levels may be noticed in patients with diabetes, which can last several days or up to one week.
  • If you were on anti-coagulation therapy or blood thinners prior to the procedure and they were temporarily stopped, please restart them as discussed.

WHEN WILL I SEE RESULTS?

  • The injection includes an anesthetic (freezing) so your relief is typically immediate. However, the pain can return after a few hours as the freezing wears off and before the steroid takes effect. The steroid typically takes, on average, 2-5 days to start working, but can sometimes take over a week for full effect.
  • Relief varies from weeks to months, depending on the joint or body part involved, severity of the disease, and the cause of your pain. Some patients get complete relief that is permanent, while others receive no significant effect. Pain injections are both therapeutic (treat symptoms) and diagnostic (identify the cause of your pain). If an injection does not help relieve your pain, then you may need further evaluation.

HOW MUCH WILL IT COST?

This exam is covered under your Alberta Health Care Plan. It is not currently offered at our Saskatchewan clinic.

For Your Appointment

Please ensure that you bring your requisition with to your appointment.

Questions?

Duration

30-40 minutes

FREQUENTLY ASKED QUESTIONS

How long does the injection take to work?

The injection includes an anesthetic (freezing) so your relief is typically immediate. However, the pain can return after a few hours as the freezing wears off and before the steroid takes effect. The steroid typically takes, on average, 2-5 days to start working, but can sometimes take over a week for full effect.

How long will the injection last?

Relief varies from weeks to months, depending on the joint or body part involved, severity of the disease, and the cause of your pain. Some patients get complete relief that is permanent, while others receive no significant effect. Pain injections are both therapeutic (treat symptoms) and diagnostic (identify the cause of your pain). If an injection does not help relieve your pain, then you may need further evaluation.

What are the potential side effects?

Feeling of heaviness, numbness or tingling on the affected leg is normal and can last for 4-6 hours. Some people also experience headaches which typically respond to caffeine, Tylenol or Ibuprofen, proper hydration and lying flat. If your headache hasn’t resolved itself after 24-48 hours, or you cannot employ the above recommendations, please see your referring physician.