(Diagnostic Transforaminal Injection)
Spinal nerves exit your spinal cord and form nerves that travel into your arms and legs. The nerves allow you to move your arms, chest wall and legs. Inflammation of these spinal nerves may cause pain in your arms, chest and legs. These spinal nerves may become inflamed and painful due to irritation, usually from a damaged disc or bone spur.
A selective spinal block nerve block provides important information to your care provider. It helps to prove which nerve is causing your pain by placing temporary numbing medicine over the nerve of concern. If your main pain area improves after the injection, then the nerve that was injected is most likely causing your pain. If you pain remains unchanged, then that nerve probably is not the cause of your pain. Confirming or denying that a nerve is your exact source of pain provides information allowing for proper treatment of your condition. Addition of steroid may help decrease the inflammation.
What will happen to me during the procedure?
An IV will be started for safety reason or to give medication for sedation, if desired. You will then lie down on the procedure table, and the skin over area to be injected will be cleansed. The physician will numb the small area of the skin where the epidural needle will be inserted. Next, the physician will use X-ray guidance to direct a small needle next to the spinal nerve. He/she will then inject contrast dye to confirm that the medicine flows around the spinal nerve. Lastly, numbing medicine will be injected along the spinal nerve to help to diagnose if that nerve is the source of your pain. A steroid (strong anti-inflammatory) may or may not be injected at the same time depending upon what is being evaluated.
What should I do and expect after the procedure?
You may have some partial numbness or weakness in the region of your body supplied by the nerve injected because of the anesthetic used. This may last several hours, but you should be able to function safely, if you take the proper precautions. You should not drive the day of the injection. If you have received sedation, you should not drive for 24 hours after the procedure.
You may take your regular medicines after the procedure, but try to limit your pain medicines the first 406 hours after the procedure so that the diagnostic information obtained from the procedure is accurate. You may notice an increase in your pain lasting for several days. This occurs between when the numbing medicine wears off and before the cortisone becomes effective. Ice will typically be more helpful than heat in the first 2-3 days after the injection.
You may return to your usual level of activity the day after the injection. If possible, it is best not to perform any unnecessary or strenuous work, sport or hobby for 2-3 days after the injection while the medicine is starting to work. If anti-inflammatory medication was injected, it will start to work 2-3 days after the injection. If your pain is improved, start your regular exercise/activities in moderation. Even if you feel significantly improved, gradually increase your activities over 1-2 weeks to avoid recurrence of your pain. If there is not improvement in 7-10 days, then a positive effect on your pain is unlikely