Finding the Cause of Your Pain with Selective Nerve Root Blocks

By Dr. Casey Muir

If you have pain radiating down an arm or leg, the most common cause is a pinched nerve in your spine. An injection called selective nerve root block can be helpful in finding the exact nerve that is causing your pain.

The nerves for your arms exit the spine from your neck or cervical region, and the nerves for your legs exit the spine in the low back or lumbar region. When a nerve is pinched, it can cause radiating pain down your limb. This is called radiculopathy. A severely pinched nerve can also cause numbness or weakness. Nerves exiting the spine are most commonly pinched by a bulging or herniated intervertebral disc. Other causes might be a cyst from a joint in the spine or arthritis, which can build up to narrow around a nerve.

Radiculopathy is diagnosed with clinical evaluation and an MRI of the affected spine region. Treatment options for radiculopathy include antiinflammatory medications, physical therapy, injections, and surgery. Often radiculopathies can improve with conservative treatments and epidural steroid injections. Epidural steroid injections place steroids down in the spinal canal around nerves that are being pinched to decrease inflammation and pain.

If there is worsening weakness, numbness, or pain despite these treatments, surgery may be necessary. However, prior to surgery being performed, it is important to maximize the likelihood that surgery will be effective in alleviating symptoms. For this purpose, selective nerve root blocks (SNRBs) are used. SNRBs are x-rayguided spine injections that place medication around a single nerve as it is exiting the spine. This allows the physician to find the specific nerve that is the source of the pain. These injections are performed in an outpatient clinic under x-ray guidance. Patients are able to go home following the injection but are given a pain journal to write down how much relief from the pain is felt for the few hours while numbing medication is effective. If the patient’s typical pain resolves, the nerve causing the pain is confirmed. This information is then used to develop further treatment plans, including help with surgical planning.

As a pain specialist at Southwest Spine & Pain, I always do my best to treat each patient individually based on their symptoms and not just treat the x-ray or MRI images. SNRBs are a tool I use to find the source of the pain and develop a plan to best relieve the pain affecting a patient’s well-being.

The physicians at Southwest Spine & Pain Center are fellowship trained and board certified to perform selective nerve root block injections and other spine interventions to reduce pain and improve your quality of life.

To schedule an appointment, go to www.swsp.com or call Southwest Spine and Pain Center: Vista Medical Center (435-656-2424), Red Hills (435-688-7246), Hurricane (435-635-0174).

About the Author

Dr. Casey Muir

Dr. Casey Muir attended medical school at the University of Nevada School of Medicine. He then did residency training in Physical Medicine & Rehabilitation at the Mayo Clinic in Rochester, Minnesota. Dr. Muir was selected by his peers and staff to be chief resident during his final year of residency. His most rewarding experiences as a resident were working together with his patients to find what pain management treatments best fulfilled their individual needs. These experiences led Dr. Muir to complete a pain medicine fellowship at Mayo Clinic in Rochester. He received training in the latest minimally-invasive pain treatments. Dr. Muir is dedicated to providing compassionate care to his patients and helping them maximize their quality of life. He uses his extensive training to treat acute and chronic pain conditions throughout the body, helping his patients get back to doing what matters most to them. When he is not working, Dr. Muir enjoys being with his wife and three daughters. He loves being outside and participating in any sport. He especially enjoys golf, soccer, and snowboarding.