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Selective Nerve Root Shots/Blocks

Comprehensive Spine Institute


The goal of this treatment is to determine the location of a specific spinal nerve root that may be the cause of the pain. Once identified, the shot at this level will provide pain relief caused by the irritated spinal nerves.



A selective nerve root block (SNRB) is an injection that delivers medication into the space around spinal nerve roots. A SNRB may also be used therapeutically for the treatment of disc herniations.


A Selective Nerve Root Injection is a more precise injection done under fluoroscopic guidance (X-Ray) using anesthetic with a long lasting steroid (“cortisone”) around the nerve root, as it exits the spinal column. This injection is sometimes referred to as a transforaminal injection.


This injection can be used as a diagnostic, as well as, a therapeutic injection. It helps us determine which nerve is irritated by “numbing” the nerve. The steroid will therapeutically reduce the inflammation and pain caused by pressure on the nerve.


A selective nerve root block is a spinal procedure in which anesthetic is placed on a specific nerve root of the spine to help identify the exact source of leg or arm pain. The injection usually also contains steroid to decrease inflammation and pain. The injection is similar to a transforaminal epidural steroid injection, but in a selective nerve root block there is no attempt to have the medication enter the epidural space but simply to cover the offending nerve root. An imaging study (e.g. MRI) may not clearly show which nerve is causing the pain or may show multiple levels of pathology and a SNRB injection assists in isolating the source of pain.

SNRBs are also used to confirm the source of pain and the specific level involved when planning spinal surgery.RISKS:This is considered a very safe procedure but there are possible risks and complications associated with them, as with all procedures, which are the following:

  • Pain at the injection site – common
  • Worsening of symptoms – occasional
  • Infection – rare
  • Bleeding – rare
  • Serious nerve or spinal cord injury – extremely rare

Other side effects are generally related to the steroid medication and may include:

  • Fluid retention – uncommon
  • Weight gain – uncommon
  • Elevated blood pressure – uncommon
  • Mood swings – rare
  • Insomnia – rare
  • Suppression of the body’s own natural production of cortisone – rare


The recovery after one of these procedures is usually quick and effective, if successful and the patient can usually return to normal activities within 24 hours.

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