Introduction
A cervical selective nerve root block is a diagnostic procedure used to identify and, in some instances, treat nerve pain in the neck. Various conditions can affect the nerves in this region, leading to pain that may radiate to the shoulders and arms. This procedure involves injecting medication directly around a suspected nerve, helping to confirm if it is the source of the pain. If the nerve root block alleviates the pain, the physician can explore further treatment options, which may include additional injections or surgical intervention.
Anatomy
The cervical spine is situated in the neck and comprises seven small bones known as vertebrae. Between each vertebra, intervertebral discs facilitate movement, enhance stability, and serve as shock absorbers. The central opening of each vertebra forms the spinal canal, which houses the spinal cord. The spinal cord extends from the brain and is a crucial component of the nervous system, though it does not occupy the entire space within the spinal canal. Instead, it is surrounded by an epidural space containing tissue, nerves, and blood vessels.
Spinal nerves emerge from the spinal cord and travel through openings in the vertebrae, known as foramina, to transmit nerve signals to the brain regarding various body parts. The eight cervical nerves are responsible for controlling sensations and functions in the head and neck, diaphragm (for breathing), as well as shoulder, upper arm, and hand muscles.
Causes
Cervical selective nerve root blocks help identify specific spinal nerve roots that may be causing pain. Conditions like herniated discs and spinal nerve root disorders, such as radiculopathy, can lead to nerve compression and resultant pain. Another contributing factor is spinal stenosis, a condition characterized by the narrowing of the spinal canal, which can exert pressure on the spinal cord and nerves.
Symptoms
The symptoms experienced will vary based on the underlying cause of neck pain. Pinched nerves in the cervical spine may lead to neck pain, tingling sensations, and numbness radiating to the shoulders, arms, and hands. Pain can worsen with neck movements, coughing, or laughing, and may be accompanied by muscle spasms in the neck. Weakness in the arms can also occur.
Diagnosis
To determine the cause of neck pain, your physician will conduct a thorough examination and may order imaging tests, lab tests, and nerve studies. A cervical selective nerve root block is employed to ascertain whether a specific nerve is responsible for the pain. In addition to serving as a diagnostic tool, this block can provide temporary pain relief.
Treatment
During a cervical selective nerve root block, an injection is administered to deliver medication directly around the targeted nerve. A local anesthetic is used to inhibit the nerve's ability to transmit pain signals, and steroid medication may also be introduced to reduce nerve inflammation.
This outpatient procedure involves lying down while your neck is sterilized and numbed with an anesthetic. You may receive sedatives to help you relax. Using fluoroscopy, a real-time X-ray imaging technique, your doctor will carefully guide a needle to the foraminal space associated with the suspected nerve. A contrast dye is injected to verify correct needle placement before delivering the medication around the nerve and removing the needle.
After the procedure, you will be monitored for a brief period before being cleared to go home. It’s advisable to have someone else drive you, as sedation will be administered. Your physician will provide guidance on managing any temporary discomfort at the injection site and will ask you to monitor your pain over the following days.
If the cervical selective nerve root block successfully alleviates your pain, it confirms that the targeted nerve was the source of the issue. Your doctor may suggest repeating the injections as part of your treatment plan or discussing surgical options if necessary. If pain persists, the procedure may be repeated on a different nerve to help identify the source of the problem.
