Dorsal Root Ganglion Block

Nerve Root Block/Transforaminal Block

What is a Dorsal Root Ganglion Block

A dorsal root ganglion (DRG) block is an injection of local anaesthetic and anti-inflammatory (low dose steroid) around the dorsal root ganglion. The ganglion looks like a small swelling on the nerve that joins the spinal cord. This ganglion contains nerves that carry sensation. It may also be called a nerve root injection. DRG blocks are used mainly for localized radicular pain (sciatica) pain when conservative management has not helped. The injection may sometimes be referred to as nerve block or a transforaminal block.

Pain relief can be short-lived although some people can get significant and lasting pain relief from these injections. The injection is usually undertaken alongside other treatments such as physiotherapy.

What happens during the procedure?

  • During the procedure, you will be asked to lie in the prone position (on your tummy). 
  • Your vital signs will be monitored throughout the entire procedure (blood pressure, oxygen saturation and heart rhythm)
  • Sedation will be given for comfort. You will be asleep, unaware and pain-free throughout the procedure. 
  • Local anaesthetic is used to numb the skin.
    A needle is directed towards the dorsal root ganglion suspected to be a source of your pain. 
  • X-ray contrast (a solution that is visible under x-ray) is used to check the needle is correctly positioned.
  • Once the target site has been confirmed, the local anaesthetic and anti-inflammatory medication will be injected close to the nerve. 
  • Radiofrequency neuromodulation may be applied to desensitize the targeted nerve root to prolong the longevity of pain relief. 
  • After the procedure you will be monitored in the recovery area until the effect of anaesthetic wears off. You will usually be discharged after about 1-2hours of monitoring

What are the possible side effects?

  • There may be some pain, bruising, and / or bleeding at the needle site.
  • You may experience mild discomfort at the site of the injection. This should not last more than 48 hours. (In about one third of patients, site discomfort can last for up to 1 week)
  • You may feel a little unsteady when you first stand. You may have some leg weakness or numbness, which should settle within a few hours. 
  • The procedure may make your pain worse. This should settle within one month. 
  • There is a small risk of infection at the site of your injections. We usually administer a dose of intravenous antibiotics during the procedure as a prophylaxis to prevent post-procedure infection. 
  • Very rarely (as the procedure is done under X-ray guidance), there is a risk of temporary or permanent nerve damage.

What will happen after my injections?

  • Waterproof dressings will cover the injection site.  You can remove this after 24 hours. Do not worry if it falls off sooner. 
  • You may notice an immediate improvement, but for some patients this improvement can take a few days. It may take 2-4 days for the steroids to take effect and about 1 week for the radio frequency modulation to take effect.
  • Sometimes there may be a slight increase in pain for 24 to 48 hours. 
  • We will follow-up with you in clinic 1 week post injection to monitor your recovery progress

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