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nerve block for diagnosis?

AnonymousUserAAnonymousUser Posts: 49,553
Has anyone ever had their doctor use a nerve block to diagnose where their pain was coming from? My doc is going to inject a block into my S1 nerve root to numb it. I have scar tissue on that nerve, so he told me if the pain goes away after the block (even for 10 minutes), they have located the source of pain. Kind of wondering if this procedure is painful, helpful or just a waste of time.



  • Have had multiple selective nerve root sleeve injections. If your pain goes away 100% then that is the level. Most of the time they do not like to give you sedation because they want you to be able to tell them how you feel afterwards. The numbing medicine is very short acting. Sometimes your leg will be temporarily "paralyzed" while the numbing medicine is there, but it will wear off quickly.

    I wish I could have a permanent pump installed that injects the numbing medicine at a couple of my levels. It took away that ouchie burning leg pain and I was upset to know that it was going to come back shortly.

    As far as injection goes, it is a little more painful than an epidural. Mine was a bit more uncomfortable because of the amount of scar tissue and having to try to go thru bone growth around nerve roots. I have to admit, I dropped the f bomb multiple times, but was able to tolerate it with no sedation.

    In my case, very helpful. Work comp approved the surgeries, proved BMP induced bone growth on the nerve root. I had many of these injections. I was nervous each time, but definitely not a waste of time. If the nerve pain goes 100% away, that's your trouble nerve.

    Good luck, keep updating.
  • thank you so much for the input. That helps me to understand the injection a little more. What is a BMP? I'm not familiar with a lot of these initials I see, because I've only had laminectomies. Do you know if I'll be able to relay to the doctors whether or not it's that nerve root that day? Or do they wait to hear from you a week or two later?

    After you had these injections, what was the next step for you? Since they found the problem, did they fix it? Were they able to fix it?

    I have the injection on the 26th of this month. Excited, but nervous too.

    Thank you again for your knowledge on this procedure.

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  • IF this injection is for diagnostic purposes, you know right away. If the numbing medicine(it's like the stuff they use for stitches) takes away the pain 100%, then that nerve root is the problem is that nerve. You know by the time you are getting off the procedure table.

    The numbing medicine wears off after 30minutes-1 hour or so, that's why they don't really like to sedate you in these situations. That way you can be perfectly clear headed on the relief you do or do not experience. Sometimes they will also inject a steroid which takes a couple of days to kick in to help with pain.

    You will have your answer that day. Kicker is you can't really take pain medicine for a little bit before hand(check with your doctor) because you need to hurt to know if injection works. If you don't hurt, they don't do the injection(at least at my doc's office.) They'll make people walk stairs to induce nerve pain if they come in pain free so that they can get a good study.

    BMP is something to help bone grow with fusions. Yes, they were able to help me with surgery because of that problem. My scar tissue is a different story, I'm kind of a whole hodgepodge of problems.
  • My experience was slightly different from ernurse's. I had a nerve block to test the L-5 nerve root. The procedure was similar to having an ESI. I was injected, and then got up, got dressed and was supposed to go about my regular activities. I kept a pain journal for 24 hours and was to record any change in pain levels and what, if anything I was doing at that time. It took about 24 hours for the numbing agent to wear off. Then I called the doctor's office and gave the nurse the report of my experience.

    The day I went in I was not in any pain (I never had pain when I was lying down or sitting.) I had the injection, went home and pushed myself with activities I would normally try to avoid. I could then make the pain happen.

    For me, the procedure was briefly painful...and in my case didn't really confirm anything.
  • Thank you for the info. I was actually a little skeptical of this procedure. I was thinking the dr. just was giving me pain medication such as cortisone. I also thought maybe he was just saying that it was diagnostic so I would do it and give him a little more income. Crazy thinking, I know. But when dr. after dr. say they don't believe what you're saying (this happened when I was 20 years old during my first surgery), you tend to be suspicious of everything. I'm glad to know that there really is such a thing as a nerve block for diagnosis. I hope (and I know this is also crazy) that this doctor gives me the option of having a fusion. I would like to have this area stable and not have to keep wondering why every little movement causes me pain.

    Thanks again.

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  • Are you sure you want this doctor operating on you, especially for a big surgery like a fusion? It doesn't sound like you have much faith in him!

    The nerve block is sometimes done instead of a myelogram as it is less invasive. It does not involve the introduction of dye into your body near your spine. Some doctors no longer perform myelograms unless there are no other options.
  • I bet they don't want to do any kind of myelogram on you if you have possible arachnoiditis.(I think that was you, right?) Any extra dye and proceedures can contribute to more adhesions. There will be a little dye(for the fluorsoscopy) but not like for a myelogram. Think nerve root block might really be a better option for you than a myelogram or MRI with contrast since you've got potential arachnoiditis.

    I always think get a second opinion, it's always a good idea. But I think your doc is right on about a nerve root sleeve injection. If it works, you'll beg to have the lidocaine in there all of the time! :)
  • I've already had a myelogram actually. That's what showed the clumped nerves. Nothing else had ever shown them before. So, unfortunately, I've already had the needle in my spine.

    I don't know if I want any doctor doing a fusion on me. I guess that's why I have so many questions. I suppose it depends on how detailed he gets in explaining the procedure. I want to know everything that can go wrong before going through with it. I do trust this doctor, but a fusion is such a risk... for anyone. And I know how I've felt for 9 months with pain after a laminectomy. So, the thought of another long recovery...well, yuck! I don't look forward to that at all.

  • I can completely understand how you feel. I waited over 3 years before I decided to go ahead with my fusion. I wasn't offered any other option. But I kept thinking if technology was such that we can routinely do lung transplants, etc., surely there is a more sophisticated technique than fusion.

    But there wasn't and I finally decided my life was getting too compromised by my level of pain.

    I would like to be encouraging, but, really, there is only so much your surgeon can tell you. There are some elements of the surgery that are just simply unpredictable. The doctor can quote all the statistics and give you his personal experiences from his patients, but he cannot say with certainty what will happen with you. And, to me, that's the scary part!

    Let me know if I can answer any questions pertaining to fusion.
  • I guess my questions about fusion are mostly concerning scar tissue and bone fusing completely. It seems like this is a huge surgery compared to a laminectomy. So, if you're opened up and cut a lot more, it seems that scar tissue would also be more...scary, since I've got scar tissue now that's causing me leg pain.

    Also, the fusing part... What if the bone fuses too much or not enough. It seems like the dr.'s would have to keep going back in to fix things. I've also heard that the screws can get loose.

    The whole thing is scary, since the back is such a touchy area. All those nerves that get in the way....

    When you had your nerve block, did it irritate the nerve more? Did you have problems FROM the nerve root block itself later on? That's another fear of mine. It seems like every little thing can irritate nerves, and then we're back in pain again.

    Did you feel like your fusion was worth it? Did it help with your pain in the long run?

    Sorry so many questions. But the more stories I hear, the better, I think.

    Thank you for all your information.

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