Selective Nerve Root Blocks in Castle Rock

What is a Selective Nerve Root Block?

A selective nerve root block (SNRB) is a minimally invasive procedure designed to diagnose and treat pain caused by nerve root irritation or compression in the spine. This treatment involves injecting a steroid medication and a local anesthetic near a specific spinal nerve root to reduce inflammation and alleviate pain. SNRBs are commonly performed when more targeted pain relief is needed compared to other epidural injections.

How does a Selective Nerve Root Block Work?

The injected steroid reduces inflammation and swelling around the affected nerve, alleviating pain and discomfort. The local anesthetic provides temporary relief while the steroid takes effect over the following days. Because the injection targets a specific nerve, this procedure can also help identify the exact source of pain, making it both a diagnostic and therapeutic tool.

What Conditions are Treated with a Selective Nerve Root Block?

SNRBs are commonly used to manage conditions such as:

• Herniated or bulging discs

• Spinal stenosis

• Sciatica (lumbar radiculopathy)

• Cervical radiculopathy (pinched nerves in the neck causing arm pain)

• Nerve root compression due to arthritis or bone spurs

• Post-surgical nerve pain

How Should I Prepare for a Selective Nerve Root Block?

Before your procedure, inform Dr. Carrera’s team about any medications you are taking, especially blood thinners and antibiotics. You may need to temporarily stop blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil, Aleve, meloxicam, and naproxen.

If you are receiving IV sedation, you may be advised to avoid eating or drinking for several hours before the injection. IV sedation is rarely needed for this procedure.

Arrange for someone to drive you home after the procedure, as you may experience temporary numbness or weakness in the affected limb. Wear loose clothing to allow easy access to the injection site.

What Happens During a Selective Nerve Root Block?

1. Patient Positioning: You will lie on your stomach on a treatment table.

2. Local Anesthesia: A numbing agent may be applied to the skin to minimize discomfort.

3. Fluoroscopic Guidance: Using real-time X-ray (fluoroscopy), Dr. Carrera will carefully guide a thin needle near the specific nerve root being targeted.

4. Contrast Dye Injection: A contrast dye is injected to confirm accurate placement of the medication.

5. Steroid Injection: A mixture of steroid medication and local anesthetic is injected around the irritated nerve root.

6. Completion: The procedure typically takes 2-5 minutes.

How Painful is a Selective Nerve Root Block?

Most patients report mild to moderate discomfort during the procedure. The local anesthetic helps numb the area, but you may feel brief pressure or mild burning as the medication is injected. When performed by Dr. Carrera, patients typically rate the pain between 1 and 4 out of 10.

Dr. Carrera uses the smallest needles possible, even smaller than those used for flu shots, to minimize discomfort.

What Should I do After a Selective Nerve Root Block?

• Avoid strenuous activities for 24 hours following the procedure.

• You may gradually resume normal activities as tolerated, following Dr. Carrera’s recommendations.

• Avoid submerging the injection site underwater for two days.

• Do not apply a heating pad or ice pack directly to the area for the first 48 hours.

• Mild soreness or temporary numbness in the leg or arm is common and typically resolves within a few days.

• Dr. Carrera may have you fill out a pain diary to assess the effectiveness of the injection and guide further treatment.

When Will I Experience Pain Relief After a Selective Nerve Root Block?

Pain relief typically begins one to five days after the procedure, with full effects noticeable in one to two weeks. Some patients experience immediate pain relief due to the local anesthetic, though this is temporary.

How Long does a Selective Nerve Root Block Provide Pain Relief?

The duration of pain relief varies among patients. Approximately 50–75% of patients experience at least a 50% reduction in pain lasting 3 months or longer. If sufficient pain relief is not achieved after two weeks, a repeat injection may be recommended, as the effects can be cumulative.

How Often Can I Get a Selective Nerve Root Block?

You can usually repeat a selective nerve root block every three months, provided you experience at least three months of 50% or greater pain relief. It is recommended to limit steroid injections to five per year across your entire body to avoid potential steroid-related side effects.

Does Insurance cover Selective Nerve Root Blocks?

Most insurance plans, including Medicare, Medicaid, and commercial insurers, cover selective nerve root blocks if the patient meets certain medical criteria. These criteria typically include experiencing pain for at least six weeks and failing conservative treatments such as physical therapy, medications, and lifestyle modifications. Some insurance companies allow for injections sooner than six weeks.

Insurance providers often require prior authorization before approving the procedure.

Who Can Perform a Selective Nerve Root Block Procedure?

Selective nerve root blocks should be performed by physicians with expertise in spinal procedures, typically interventional pain specialists or physical medicine and rehabilitation (PM&R) specialists.

Dr. Carrera is double-board certified in interventional pain medicine and PM&R, making him uniquely qualified to perform SNRBs with precision and safety.

Dr. Carrera performs these injections in an in-office procedure suite, which helps patients save significant costs compared to a surgery center. Additionally, he uses exceptionally small needles, even smaller than those used for flu shots, to maximize patient comfort.

While some offices can take up to six weeks to schedule a selective nerve root block, Dr. Carrera’s team can typically perform the procedure within 2 to 7 days of your initial visit, ensuring timely pain relief.

Should I get a Selective Nerve Root Block?

If you are experiencing chronic nerve pain, sciatica, or radiating arm or leg pain, and are wondering if a selective nerve root block is the right treatment for you, a consultation with Dr. Carrera and his team can help determine your eligibility.

Patients in Castle Rock, Lone Tree, Highlands Ranch, Parker, Denver, and surrounding areas are encouraged to call the office at 720-455-3775 to schedule a visit and learn more.