Image Guided Nerve Root Injections

Doctors might offer you this procedure if you have an inflamed spinal nerve due to a herniated disc. Alternatively it may be suitable if you have bony spurs causing nerve compression or a condition like scoliosis. The nerve may have become irritated or compressed resulting in pain, which may be severe. If more than one nerve is affected you may be given multiple nerve block injections.

For the procedure your doctor will ask you to lie on a treatment table. This table is situated next to the imaging machine (X-ray machine or CT scanner). After cleaning the skin above the affected nerve root, we will give you an injection of local anaesthetic to numb the entire area.

Once you are unable to feel any pain, we will give you an injection of corticosteroids. These help to relieve pain and reduce inflammation in the damaged area. Your doctor will use imaging to guide the needle so that the steroid is administered in exactly the right place.

If we are using X-ray guidance we may inject a harmless dye into the affected area first. This is so that we can see the needle tip is correctly positioned. After the procedure you will be able to go home the same day.

You should avoid doing anything too strenuous for 24 hours. In addition we will ask you to keep a diary of how your symptoms feel over the next few weeks. This is so we can assess how successful the treatment has been.

Patients receiving an injection into the cervical spine report significant improvements. In fact pain levels and functional ability are better in 57% of cases. It is slightly lower in patients who are injected into the lumbar spine (46%).

In some cases, sadly, patients do not experience pain relief. Alternatively it is short-lived (just a few weeks). Sometimes the therapeutic effect of the injection may not occur for a few days or weeks. This is because it takes time for the steroid to become more effective. Patients who do strengthening exercises and physiotherapy generally report better outcomes. For this reason we recommend this to patients who undergo the procedure.

Image guided nerve root injections are very safe procedures and any risks are rare. There is a small risk of bleeding or infection associated with any type of injection. However the skill and experience of our radiologists means that any problems of this type are rare. If you are taking a strong anticoagulant (such as warfarin) or you have a bleeding disorder, please discuss this with your consultation radiologist.

In some cases, you may experience temporary muscle weakness for a few hours after the procedure. This is caused by medication affecting the nerve fibres and will quickly wear off. If you have infection elsewhere in your body or sepsis we generally would not give a joint or soft tissue injection as it could prolong or worsen the infection. More serious risks include spinal cord damage, pneumothorax, allergic reaction, infection or bleeding.