1. What is blockade
Nerve root, ganglion and nerve blockades are injections under a local anesthesia (various medicinal products) and steroids. Blockades are prescribed by an attending physician with skills in pain relief determining a certain type of blockade. Nerve root, ganglion and nerve blockades can be diagnosed with various types of physical examination. However, the main conclusions must be based on a clinical finding (determining the cause of pain and therapy for pain relief). If your pain decreases after the blockade or course thereof, the treatment can be repeated. Sometimes blockades allow to find out whether surgical intervention – and to what extent – is required; and to what maximum level such treatment is necessary.
The procedure cannot be done if you have an active infection (e.g. runny nose, cough, fever, high blood pressure).
3. What preparation must be done before the procedure
Avoid heavy foods or beverages before the procedure. You must use your medication with small amount of water. People with diabetes should avoid using medicines before the end of the procedure. Blood sugar levels should be measured at home before the surgery. If you use blood thinners (Comodine, Warfarine, Plavix) or any products of this group, you must inform your doctor about how many days before the procedure you stopped using any of these medicines and what medicines were prescribed by your general practitioners before you stopped using them.
4. What is the risk of the procedure
Just like in case of most of the procedures, there might be some bleeding, infections, nerve damages, allergic reactions to medicines. Temporary side-effects will disappear. You can feel nerve numbness if the nerve is blocked. You can also experience some weakness. If that is the case, you must stay at the clinic, usually for couple of hours. The pain will gradually disappear over the course of the next few days, also around the injection site. People with diabetes might experience elevated blood sugar levels due to the use of steroids (sugar level must be adjusted).
5. Are blockades very painful
Most of the patients complain about numbness, burning sensation, and pain during the procedure. This can vary from patient to patient. For example, if you experience shooting pain during the procedure, injection is close to a nerve.
6. What happens during the procedure
The blockade takes place under sterile conditions; if necessary, an anesthesiologist is invited and X-ray imaging is used. Please inform your doctor if you are allergic to X-ray radiation, or if you do not like them, or if you have been exposed to large doses of radiation. After the blockage during which a needle is used to introduce medicines into you body, the needle is removed. Your skin is then sterilized, dried and dressed. The dressing must come off the next day. After the blockage you must rest for 20-30 minutes, paying attention to your blood pressure. You can write, talk on phone, but it is advised that you head back home accompanied by a driver or any other person. We advise against driving
7. How will the patient feel after the injection
Your pain will be alleviated by local anesthesia. Steroids in most of the cases will show results in 1-3 days, but sometimes it takes longer. Couple of days after the procedure you might experience local weakness which might be decreased by applying a cold compress to the injection site 3-4 times a day. You must use your regular painkillers after the blockage. It is important to check for how long your regular painkillers are effective after the blockade (effect might increase).
8. What must be avoided on the day of blockade
Avoid driving for one day after the blockade. Adults (older than 18) can take taxi to get home. If the patient is a minor, the procedure cannot be done without parental consent (for your safety). Do not heat the injection site in warm baths, shower (including pools, Turkish, Finnish saunas etc.) for at least a day. Continue your regular diet and use of medicines after the procedure.
9. In what cases a patient should return to a pain management clinic
We need to know how long your pain remission period has been (for how long this has happened). If you experience strong pain, elevated body temperature or headache which does not disappear after the use of your regular painkillers, or if there is signs of infection around the blockage site (redness, burning sensation, heat), you must immediately come back to the clinic.