What has gone wrong?
You have suffered general wear and tear (degeneration) or damage from an injury to the intervertebral discs in the spine. When the disc is inflamed the nearby nerves become irritated. These nerves supply sensation to the limbs. When the nerves are irritated, the brain is fooled into believing that the limb is injured. This is not the case; the problem is in the spine. Sometimes the nerve itself is damaged without an intervertebral disc problem.
The aim of the procedure is to reduce the inflammation of the disc and therefore relieve the irritation of the nerve next to it. This reduces arm or leg pain and some of the spinal pain. Damaged nerves can also be treated directly with injections around the nerves themselves.
Your pain should be reduced and you should be able to move around more easily. You can then exercise to prevent the problem happening again. If successful, this treatment can avoid the need for surgery.
Are there any alternatives?
By the time that you have the dorsal root ganglion block you should have already tried other more simple treatments. These include rest, painkilling and anti-inflammatory tablets, and physiotherapy with exercise.
What if you do nothing?
If you do nothing there are several things that may happen:
With time and rest the inflammation and pain may settle on its own
The pain and difficulty in moving around may remain the same
The pain may increase
The disc may become further damaged and injure the nerves that control movement. You may then develop weakness and difficulty moving your legs or arms. Some of this may be permanent
In severe cases you may lose control of your bladder and bowels as the nerve that controls them may be damaged
Who should have it done?
The following groups of patients should have the procedure done:
Patients with limb pain caused by inflamed discs
Patients with pain from damage to a single nerve
Patients with low back pain that has not settled by other means
Who should not have it done?
Each patient must make the final decision to proceed or not. If you are unhappy about the procedure for any reason you should not continue.
There are specific medical situations when a dorsal root ganglion block should not be done and they are as follows:
When a patient is on medication that prevents their blood from clotting, such as warfarin. This would lead to more bleeding than normal. It may be possible to stop the medication a few days before the procedure. This will need to be discussed with your doctor
When a patient is suffering from an illness that prevents blood from clotting, such as haemophilia. This would also lead to more bleeding than normal
When there is infection of the skin over the site where the needle needs to be put in
When a patient has a bloodstream infection
Author: Dr Sean White FRCA. Consultant in pain and anaesthesia.
© Dumas Ltd 2006