Thoracic Nerve Root Blocks

What is a Nerve Root Block?

A nerve root block is typically an injection onto the sheath surrounding a nerve root in the spine. The aim of a nerve root block is to decrease the pain temporarily and then define it more precisely.

A selective nerve root block is primarily used to diagnose the specific source of nerve root pain and secondarily, for therapeutic relief of low back pain and/or leg pain.

Pain relief from the procedure of a nerve root block varies from minimal to long-term, depending on the specific symptoms.

When is a Thoracic Nerve Root Block used?

A thoracic (of mid back) nerve root block is carried out to indicate towards the nerve causing pain by placing temporary numbing medicine over the nerve root of concern.

If the usual pain improves after the injection, the nerve in concern is most likely causing the pain. By confirming or denying the exact source of pain, it provides information facilitating proper treatment that may further include additional nerve blocks or surgery at a specific level.

What is the procedure?

A procedure for thoracic nerve root block generally follows the below listed steps:

1. An IV will be started in order to administer the relaxation medicine.
2. The patient will be asked to lie down on the x-ray table and positioned in a manner, which will allow the physician to best visualize the bony openings in the spine, where the nerve roots exit the spine.
3. The skin on the back is then scrubbed using two types of sterile scrub.
4. The physician numbs a small area of skin with a numbing medicine, which might sting for a few seconds.
5. Once the numbing medicine has had the desired effect, the physician directs a very small needle, using x-ray guidance near the specific nerve being tested.
6. A small amount or contrast (dye) is injected to insure proper needle insertion, which might increase the pain for about 30 minutes.
7. Finally, a small mixture of a numbing medicine (anesthetic) ad anti-inflammatory (cortisone/steroid) is injected.

What happens after the procedure?

Once the procedure is over, the physician will ask the patient to imitate something that would normally bring about the usual pain. The patient is then asked to report the percentage of pain relief and record the relief experienced during the next week on a post injection evaluation sheet.

In addition, the arms, chest wall or legs may also feel weak or numb for a few hours after the procedure.

Should I follow any precautions?

The following set of precautions is normally advised for a patient about to undergo a thoracic nerve root block:

1. Eat only a light meal within a few hours before the procedure.
2. Do not change your normal eating pattern, if you are an insulin dependent diabetic.
3. Do not take any pain medications or anti-inflammatory medications on the day of the procedure.
4. Notify your physician if you are on Coumadin, Heparin, Plavix or the diabetic medication Glucophage.