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Reasons for procedure
Description of procedure
After the procedure
Risks associated with this procedure
Other important information
Download Procedure Description ( PDF Format )
Reasons for procedure:Your doctor has requested this procedure because you have neck, shoulder, arm and/or hand pain. There are two major reasons to perform this procedure: to determine whether a particular nerve is causing your symptoms, and to provide temporary pain relief. Although these goals are usually achieved, it is impossible to guarantee that the cause of your pain will be identified, and that your pain will be decreased. The period of relief is different in each patient.
Description of procedure:
The procedure is performed in a special room in the radiology department and takes about 30 minutes. You will lie on your back and must be able to turn your head.
Your skin will be cleaned with an antiseptic soap, and then numbed with a local anesthetic. Using fluoroscopy (continuous x-ray), the radiologist will pass a needle next to the nerve that is believed to be causing your pain. A very small amount of contrast dye will be injected to confirm correct needle position, and then the medications will be injected. During the injection, you may feel mild pressure or tingling in your neck or arms. These sensations are normal and will only last several seconds. Please inform the radiologist if you feel these sensations, as it will help to diagnose the exact source of your pain.Two different medications are injected around your nerve. A short-acting anesthetic agent is injected for diagnostic information. If your pain is relieved immediately following the procedure, it will come back after the anesthetic agent wears off in about 1 to 2 hours. An anti-inflammatory steroid is injected for longer-lasting pain relief, but it will not begin working for 1 to 2 days. The steroid reaches maximum effectiveness in 5 to 7 days. The duration of relief depends on many factors, including the severity and reversibility of your condition.
After the procedure:You will receive discharge instructions as well as a pain diary to record the changes in your symptoms. You will not be allowed to drive, however you can leave the hospital immediately if you have someone who can drive you home and stay with you for 2 to 3 hours. The short-acting anesthetic can make your arms feel numb or weak for 2 to 3 hours. You should minimize activity during this time, and then resume routine light activities as tolerated. Avoid any strenuous activity or heavy lifting for 7 days.
Risks associated with this procedure:
Complications are infrequent but possible. The needle could cause local bleeding or infection. Rare neurological complications have been reported, including permanent numbness in the nerve distribution. Other risks include: allergic reaction to the x-ray dye or anesthetic medication and temporary arm weakness. Pain may be temporarily worsened after the procedure.
IMPORTANT:
- Please call us 24 hours ahead of time if you need to cancel or reschedule your appointment: (617) 726-7717
- Please bring your most recent MRI or CT scans of your spine to your procedure.
- If your symptoms are mild, do not take pain medications before the procedure.
- If you answer "Yes" to any of the following questions, please call and tell us prior to your appointment.
- Are you allergic to shellfish or x-ray dye (contains iodine)?
- Do you have diabetes?
- Do you take Coumadin or other blood thinners?
- Are you being treated for an infection?
