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Cervical Selective Nerve Root Block - Neck

Introduction
A cervical selective nerve root block is used to diagnose and in some cases, treat nerve pain in the neck.  A variety of conditions can affect the nerves in the neck, which not only can cause pain in the neck, but pain that spreads to the shoulders and arms.  A cervical selective nerve root block places medication directly around a suspected nerve to help determine if it is the source of pain.  If the selective nerve root block relieves the pain, then the doctor can proceed with treatment, which may include additional medication injections or surgery.

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Anatomy
The cervical area of your spine is located in your neck.  Seven small bones (vertebrae) make up the cervical spine.  A disc between each bone allows movement, provides stability, and acts as a shock absorber.  The opening in the center of each bone forms the spinal canal. 

Your spinal cord is located within the protective spinal canal.  The spinal cord extends from the brain and is a major part of your nervous system.  The spinal cord does not fill the entire space in the spinal canal.  Instead, the spinal cord is surrounded by the epidural space (cavity), which contains tissue, nerves, and blood vessels.

Spinal nerves extending from the spinal cord travel out of openings or “tunnels” in the bones (foramina) to exchange nerve signals with your brain about specific parts of your body.  The eight nerves at the cervical level control body functions and sensation for your head and neck, the muscle used for breathing (diaphragm), shoulder and upper arm muscles, and muscles of the wrists and hands.

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Causes
A cervical selective nerve root block is used to identify if a particular spinal nerve root is the source of pain.  Ruptured (herniated) discs and spinal nerve root diseases (radiculopathy) can contribute to pinched or compressed nerves and lead to pain.  Another possible cause, spinal stenosis, is a condition that causes the spinal canal to narrow and put pressure on the spinal cord and nerves.

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Symptoms
The symptoms that you experience depend on the cause of your neck pain.  Pinched nerves in the cervical spine can cause neck pain, tingling, and numbness that radiates to the shoulders, arms and hands.  The pain may become worse when you move your neck, cough, or laugh.  Your neck muscles may spasm.  Your arms may feel weak.

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Diagnosis
Your doctor will examine you and conduct tests to determine the cause of your neck pain.  Imaging tests, lab tests, and nerve studies may be used to provide your doctor with more information.  A cervical selective nerve root block is used to determine if a specific nerve is the source of pain.  In addition to being a diagnostic tool, a cervical selective nerve root block can help temporarily relieve pain.

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Treatment
A cervical selective nerve root block uses an injection to place medicine directly around a suspected nerve.  A local anesthetic medication is used to “turn off” the nerve, stopping its ability to send pain signals.  Steroid medication may be added to help decrease nerve inflammation.

A cervical selective nerve root block is an outpatient procedure.  You will wear a gown for the procedure and be positioned lying down.  Before you receive the selective nerve root block, the back of your neck will be sterilized and numbed with an anesthetic.  You will receive relaxation medicine before your procedure.

Your doctor will use a live X-ray image (fluoroscopy) to carefully insert and guide the needle to the foraminal space “tunnel” of the suspected spinal nerve.  A contrast dye is used to confirm the needle placement.  Next, the medication is injected around  the nerve, and the needle is removed.

You will be monitored for several minutes before you can return home.  You should have another person drive you home because you received sedation medication.  Your doctor will instruct you on how to relieve temporary pain at the injection site.  You will be asked to keep track of your pain over the next several days. 

If the cervical selective nerve root block relieved your pain, then the suspected nerve was the source of the problem.  Your doctor may repeat the injections as a form of treatment or discuss surgery if necessary.  If the cervical selective nerve root block did not relieve your pain, the process may be repeated at a different nerve to help determine the source of the problem.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.