What is a Nerve Root Block Injection?  

This is an injection around the nerve root as it leaves the spine.

Why do I need to have the injection?

The injection is usually done to relieve pain and inflammation around the nerve. It is used to help leg pain (sciatica) and paraesthesia (pins and needles) and is sometimes used for back pain. The injection may also be useful to help diagnose the source of your pain.

Who does this procedure?

The injection is usually done by a doctor in the injection room in the Outpatients (OPD) Injection Suite. They will use an X-ray machine to guide the injection.

What is injected?

• An anti-inflammatory drug (steroid)
• A local anaesthetic.  
• A small quantity of dye is also injected so that the Doctor can be sure that the injection is around the nerve.

The local anaesthetic will be responsible for any immediate relief of symptoms. When this wears off the pain may return before the benefits of the anti-inflammatory is felt. The anti-inflammatory drug may take up to 6 weeks to work. Pain may return after some time. If this occurs a decision will then be made about repeating the nerve root injection or considering other possible treatments.

Before the injection

You can eat and drink as normal before your procedure.

Important information

Please inform the Outpatients department staff if you are:

• diabetic,
• feel unwell,
• have an infection, cold or persistent cough,
• have any allergies,
• taking any of the following medication: Antibiotics, Asprin, Warfarin or Clopidrogrel or any other tablets used to thin the blood (some of these may need to be stopped some days before). Failure to do so may result in the procedure being cancelled.  

As it is necessary to use X-rays during this procedure, you must inform the clinician referring you if you are pregnant or trying to get pregnant. If you find you are pregnant before the procedure, please inform the Outpatients Injection Suite staff.  

What are the risks of this procedure?

Possible risks are:

• Infection.
• Damage to the small veins on insertion of the needle.
• Bleeding causing local bruising or bleeding around the nerve.
• Damage to the lining around the nerve which may cause a severe headache for a few days.
• Nerve damage.
• Allergic reaction to the injection which may be mild or life threatening (anaphylaxis)
• Urinary complications (incontinence or difficulty emptying your bladder).
• If you are diabetic, then the injection may raise your glucose levels. These should be monitored for up to 1 month after the injection. If there are any changes in your diabetic symptoms, please consult your GP.
• Facial flushing for a few days.
• Temporary discomfort for a few days after your injection.
• For females - temporary alteration of your menstrual cycle.

Risks from having a nerve root block are small, please discuss any concerns with the clinician looking after you.

On the day of your procedure

• Please arrive at the Outpatients Department no more than 10 minutes before your appointment time.    
• Take any medication as normal unless advised otherwise. Bring a list of your tablets with you.
• You will be admitted to the OPD Injection Suite and will be assessed by a member of the clinical team. This is to make sure you are fit and ready for the injection. You will have the opportunity to ask any questions at this stage.
• The doctor carrying out your injection will also see you before your procedure.

What the procedure involves

You will be lying on your front for the procedure, which usually takes 10-20 minutes. Local anaesthetic is injected into the skin and a fine needle is passed toward the nerve root under X-ray guidance. Once the needle is confirmed to be close to the nerve, the injection takes place.

What happens after your procedure?

You will be monitored by the nursing staff until you are ready to go home (about 30 minutes). You must not drive yourself home or use public transport. For your own wellbeing we advise that you are collected by a relative or you arrange a taxi.

Back at home

• It is important that you take things easy for the rest of the day.
• Do not do any excessive exercise or heavy work for the first few days.
• If a dressing is in place, remove the dressing the morning following your procedure.
• Continue to take your pain relief tablets until you notice an improvement in your symptoms.

Who do I contact if I have any problems following the procedure?

From 9am – 4pm you can call the OPD Injection Suite on 0121 685 4000 extension 55814 or contact the secretary for the clinician you are under. Outside these hours contact the bleep holder through switchboard: 0121 685 4000.

Follow up appointment                                     

Need for a follow up appointment will be discussed before you are discharged.

Can’t make your appointment?

If for any reason you cannot make your appointment, you must let the care coordinator know as soon as possible on 0121 827 3835 Mon-Fri from 8.30am to 4.00pm. Your appointment will not be automatically re-booked unless you call to tell us you are not able to attend.

Useful contact numbers

PALS - 0121 685 4128
Care Coordinator - 0121 827 3835
Outpatients Injection Suite - 0121 685 4000 extension 55814