Nerve root block involves injection close to the nerves as they come out of the spine. It is used in conditions where there is compression/ pressure on the nerve as it comes out of the spine. This injection helps in delivering maximum drug close to the area of actual pathology- disc bulge/ nerve compression with a favorable response especially if the procedure is performed soon after the onset of symptoms. The needle is placed under x-ray guidance and a dye (contrast agent) is given to check needle position prior to giving the local anaesthetic and steroid mixture. These injections can provide diagnostic information and therapeutic benefits.
Epidural space is present in the spine around the sac containing the spinal cord and the nerves. It extends from the back of the head to the bottom of spine. Epidural injection involves placing a needle in this space under x-ray guidance. A dye (contrast agent) is used to confirm needle placement before a mixture of local anaesthetic and steroid is given. The level at which the injection is performed will depend on the actual pathology site and the pain distribution.
Depending on the level at which the epidural injection is performed, it may be termed as
- Cervical epidural – Indicated for neck and arm pain. It involves performing an injection at the base of neck under x-ray guidance
- Thoracic epidural - Indications for this injection include mid back, chest or abdominal pain. It is performed at mid back level between the shoulder blades, under x-ray guidance.
- Lumbar epidural is performed for back, groin or leg pain. It involves a x-ray guided injection in the lower back at the waist level
- Caudal epidural is performed for back and leg pain. It involves a x-ray or ultrasound-guided injection close to the lower end of the spine near the tailbone.