Each nerve coming out of your spinal column has two parts: the anterior root, which carries motor signals to the muscles and the posterior root, which brings in pain and sensory signals.

Individual nerves can be injected with local anesthetic solution to stop the pain signals from reaching the brain. This can help identify which levels to treat to help reduce pain.

Prior to the injections an intravenous line (IV) will be started and you will be placed on a monitor that will check your blood pressure, heart rate, and the oxygen in your blood. You will lie on your stomach supported by pillows and be given sedation before starting the procedure. Patients experience reduced anxiety and pain and sometimes have amnesia with these medications. A radiology technologist will use an x-ray machine to locate the openings along the sides of your spine that are to be injected. Your back will be cleaned with a special solution and be covered with sterile drapes. The doctor will numb the injection sites with local anesthetic. You will feel pressure sensations in your back as the doctor inserts the needle, and mild discomfort while placing the needle in the correct position. The doctor will then inject a small amount of local anesthetic mixed with long acting steroids into the area of the nerve after confirming the position using x-ray dye. This may be repeated several times. You will then be taken to the recovery room and continue to be monitored.

• There are very small risks of bleeding or infection at the injection sites.
• The procedure may make no change in your pain, make it worse, or cause residual pain.
• Although very rare, damage to the spinal nerve or spinal cord near the injection site may cause the following: paralysis or partial muscle weakness, persistent numbness, or injury to blood vessels.
• Rarely, reactions to the local anesthetic drugs can cause flushing, ringing in your ears, or very rarely, seizures.
• Allergic reactions to medications may cause your heart and breathing to stop, damaging your brain, heart, lungs, liver, kidneys, or may cause death.

• You may experience increased pain for 24 to 48 hours after the injections.
• Temporary numbness, tingling, or weakness in one or both legs or arms may occur, depending on whether your injections were in the neck or lower back. These sensations will wear off within a few hours. If these sensations continue or worsen beyond that which is described by your doctor, call the Pain Treatment Center or the on-call doctor.

It is not possible to predict to what extent, if any, this treatment will relieve your pain. It is important to note the amount of relief you get after this procedure and the length of time the relief lasts. These injections are usually used to identify the levels for further treatment using radiofrequency lesioning, a technique to gently heat the sensory nerves carrying the pain signals to decrease their ability to conduct pain signals.