Receiving a nerve block for herniated disc treatment is a common moderate treatment practice typically used for cases of suspected foraminal or lateral recess stenosis enacted by an intervertebral pathology. Nerve blocks are utilized throughout the back and neck pain therapy community to treat an incredibly diverse range of suspected problems in the spine; all of which are theorized to somehow negatively influence the function of one or more spinal nerve roots.
Nerve blocks are basically anesthetic injections that have a long duration to their numbing effects. They are specifically targeted to treat nerve roots that are suspected of being involved in the symptomatic expression using other diagnostic evaluation procedures, such as MRI or discography.
Due to popular reader demand, we are providing this guide to help patients make better choices when it comes to the decision as to whether or not nerve block injections are indicated for their herniated disc-related pain. Furthermore, we will detail the positive effects of nerve block injections, as well as their possible risk factors which should always be considered before undergoing treatment.
Nerve blocks usually contain both anesthetic and anti-inflammatory components, such as lidocaine, various corticosteroids and organic anti-inflammatory agents, such as epinephrine. The goal of treatment is to decrease any “inflammation” around the affected nerve, as well as deaden nerve signals to reduce pain experienced due to compression or chemical irritation enacted by a bulging or ruptured intervertebral disc.
The anesthetic substance(s) will reduce nerve signaling or pain messages to the brain, hopefully reducing symptoms. Meanwhile, the anti-inflammatory agents will act on any swelling that exists, although as proven by countless research studies, there is no evidence that any inflammation exists in the overwhelming majority of back and neck pain syndromes, including those enacted by herniated discs. This is one of the main reasons why many forms of oral and injectable drugs remain hotly-debated for herniated disc therapy and why there remains a distinct lack of scientific logic in the use of these profitable substances in virtually every case.
Nerve blocks are rarely used as preliminary treatment modalities. Instead, they are often reserved to be considered after the more conservative means of care fail, which is commonplace in the back and neck pain treatment arena. In most cases, nerve blocks will be utilized after confirmation of an intervertebral herniation using MRI imaging and correlation of symptoms leading back to an affected nerve root. In many cases, discogram testing might also be used to narrow down a specific disc and nerve as the exact source of pain.
Once decided upon, the injection is actually a relatively easy procedure to perform, being undertaken as an outpatient therapy and only taking a few moments to complete. The patient should be treated using live x-ray imaging for best and most accurate results. A long needle will be inserted into the spinal anatomy, into the proximity of the affected nerve. Once in place, the contents of the syringe will be released. Since the nerve itself will never be visible, even when using the best fluoroscopy equipment, the placement of the injection is based on educated guesswork and clinical experience. Once the drugs have been injected, the patient will be monitored for a time then allowed to leave the doctor’s office and return home to rest and report the results of the injection over the next several days and weeks.
Nerve blocks are used to treat specific and unspecific forms of pain that are suspected of involving particular nerve roots in the spine. These roots may be victimized by structural compression, displacement, impingement or protein irritation, commonly as known as chemical radiculitis.
When it comes to herniated discs, nerves can be compressed or displaced by a bulge, herniation, rupture, sequestration or extrusion. Chemical radiculitis can only occur is an annular tear exists, disc nucleus proteins exit the disc and contact the nerve, and the patient demonstrates a susceptibility to painful irritation due to this protein.
Nerve blocks can also be used to treat many other non-disc-enacted forms of back and neck pain, such as those involving the same nerve roots, but caused by arthritis, stenosis, atypical spinal curvature, vertebral misalignment and other causes.
The upside of nerve block treatment is that it is less invasive than surgical methods of care and might provide good results for some patients. In the best case scenario, the patient will enjoy marked pain relief for several weeks to several months, but will then statistically have to decide how to proceed with continuing care when the pain returns.
In many, many instances, the nerve block only provides a few days to a couple of weeks of relief, making it seem less worth the risk of this minimally invasive injection technique. Some patients report a complete lack of positive results, while a small minority of patients cites worsening of pain immediately following a nerve block injection.
Nerve blocks are purely symptomatic treatment and can only provide temporary benefits, if any at all. Furthermore, they will never act to resolve the cause of the pain, which may or may not be the herniated disc implicated in the clinical manifestation of pain.
Risks of epidural nerve blocks are many and varied. These include poor treatment outcomes, worsening of symptoms and more serious occurrences, such as spinal fluid leaks, infection and nerve trauma.
In some scenarios, spinal fluid will continue to leak from the thecal membranes and might cause significant symptomology, including intractable headaches. In a few patients, surgery will have to be performed to seal chronically-leaking CSF conditions.
Infection can occur in the disc itself (called discitis) or within the spinal structures, including widespread infection of the cerebral spinal fluid that might involve a meningitis condition.
Nerve trauma might result in permanent or temporary reduction of signal capabilities and might cause motor or sensory impairment.
Serious complications are rare and can be reduced by undertaking care with an experienced provider who utilizes the latest technologies to perform the procedure. However, complications can always develop and might be severe, so all risks should be discussed with the physician ahead of the procedure and considered carefully, especially since substantial rewards are not assured by any stretch of logic or imagination.