Blocks - spinal injections

A number of problems in the spine can present as "nerve pain" that is sharp pain radiating along the pathway of a particular nerve (or nerve root - the root being the portion of the nerve which leaves the spine) such as the sciatic nerve. Often this pain can be overcome by an injection designed to partially numb the nerve and to reduce the inflammation in it which is frequently the cause of the pain.

Many patients, alternatively, suffer from a chronic nagging pain due to a more generalised inflammatory process. Spinal injections can significantly ease this type of inflammatory response in the majority of patients.  

Patients undergoing these types of spinal injection will be offered a sedative to settle them for the procedure. Not all patients will need this, but it is available if required.

These blocks are of two types:-

General Blocks -  These are performed under local anaesthetic using x-ray control to ensure both safety and maximum efficacy.  They are performed in the day case surgery unit, in London at The London Clinic. or Chelmsford, at the Chelmsford Medical Centre.   The procedure does not take long (20 – 30 Minutes at most) and is often very effective. It is be performed on an out-patient basis and the patient can return home the same day.  There is often some flare-up of symptoms for a day or two after the procedure, but the effect becomes most marked by around 5 days.  The effect may last for only a short while (a few hours) or may continue for several days or weeks.  Many patients will experience lasting benefit.

Local Blocks - e.g. facet joint injection. These are also performed as an outpatient under local anaesthetic. They can be used to diagnose problems, by specifically blocking pain from one site using local anaesthetic to determine precisely which area of the spine is causing the pain in life.  Thereafter they can be used therapeutically to reduce the inflammatory reaction, which is often the major cause of spinal pain.

Blocks may need to be repeated after an interval, as the inflammation may come back especially if the underlying cause, such as obesity, has not been treated. 

These procedures are performed by Dr Sean White, Mr John Sutcliffe and Mr Dan Plev,  using x-ray control, to ensure that the needle position is optimum and that the patient experiences as little pain from the procedure as possible.  Sedation or even general anaesthesia can be administered if required, but most patients cope well with local anaesthetic.

After having a pain procedure your co-ordination may be affected and logical thinking may be difficult due to the effects of local / general anaesthetic drugs.

During the first 24 hours, please DO NOT:

          - drink alcohol

          - make important business or life decisions

          - drive or operate machinery (including using a cooker)

          - take sleeping tablets

For more information regarding specific procedures, visit www.themediweb.net/pain/index.htm