An inflamed spinal nerve in your neck (cervical spine) may result in neck, shoulder, and/or arm pain. In response, your doctor may advise you to get a cervical selective nerve root block injection to help locate the spinal nerve that is pinched or inflamed, and also to relieve your pain. Here is how this procedure works.
When a selective nerve root block is considered
When neck and arm pain persist despite rest and other nonsurgical treatments, a cervical selective nerve root block may be considered. Although pain is the most common symptom, other symptoms and signs often occur in both the neck and/or arm including numbness, tingling, weakness, burning or other strange feelings called paresthesia.
The exact symptoms that you feel can vary but in the neck you most frequently feel pain and stiffness or reduced range of motion; and in the arm you will most likely experience a combination of pain, numbness, or tingling. The goal of this injection is to reduce inflammation for a suspected spinal nerve that is inflamed. Common conditions that might compress or inflame a spinal nerve include:
- Cervical osteoarthritis (joint swelling and bone spurs that encroach upon the nerve)
- Cervical degenerative disc disease
- Cervical herniated disc
- Cervical foraminal stenosis
Reducing inflammation in the pinched or irritated nerve may help relieve neck, arm, or hand pain or paresthesia caused by the inflamed spinal nerve.
Cervical selective nerve root block procedure
A typical cervical selective nerve root block injection procedure takes about 30 minutes and involves these general steps:
- To begin a cervical selective nerve root block procedure, your doctor will have you set up in a procedure room with the area of your neck to be injected exposed and sterilized. He or she will then inject a local anesthetic into your skin over the painful area.
- With the help of fluoroscopy (X-ray guidance) and contrast dye, your doctor positions the needle near the nerve that is suspected of being the cause of your pain. Sometimes ultrasound is used to help visualize where to place the needle instead of fluoroscopy.
- When your doctor is satisfied that the needle is in the correct position, she or he will inject both lidocaine, a type of anesthetic, as well as a steroid, such as cortisone, around the nerve root near the point of irritation.
After the cervical selective nerve root block, most people can go home soon and are advised to take things easy the rest of the day.
Efficacy of cervical selective nerve root blocks
If a cervical selective nerve block at least temporarily relieves the pain, it can also play a key role in confirming which nerve is causing the pain. A cervical selective nerve root block injection can be used to both diagnose and treat an inflamed spinal nerve.
Although the effects of the anesthetic wear off relatively quickly, the effects of the steroid shot typically last for a longer period of time. This in turn can help reduce inflammation (and thereby relieve your pain), and also promote the healing of the irritated nerve.
Estimates for the efficacy of cervical selective nerve root blocks vary. One study found that 67% of patients reported significant reduction in pain at 3 months after the injection, and 57% still reported benefits at 6 months after the injection. 1 Park KD, Lee WY, Nam SH, Kim M, Park Y. Ultrasound-guided selective nerve root block versus fluoroscopy-guided interlaminar epidural block for the treatment of radicular pain in the lower cervical spine: a retrospective comparative study. J Ultrasound. 2018. doi:10.1007/s40477-018-0344-z
Potential risks and complications
While a cervical selective nerve root block is generally considered a low-risk procedure when performed by a qualified medical professional, risks and complications may include:
- Nerve or spinal cord damage
- Allergic reaction
Before choosing to have a cervical selective nerve root block, ask your doctor about the potential risks and benefits.
Read more about Selective Nerve Root Block Injections
- 1 Park KD, Lee WY, Nam SH, Kim M, Park Y. Ultrasound-guided selective nerve root block versus fluoroscopy-guided interlaminar epidural block for the treatment of radicular pain in the lower cervical spine: a retrospective comparative study. J Ultrasound. 2018. doi:10.1007/s40477-018-0344-z