What is a block?
A block is an injection of a mixture of a local anesthetic (like 'sensorcaine') medication and a strong anti-inflammatory (a steroid, like 'kenalog') medication at a specific site in an attempt to control inflammation and pain. Block procedures involve placing a small needle into the area of your spine where the pain is located. These blocks are very safe procedures when properly done.

Do blocks always work?
In general, there is about a 70 to 80% incidence of improvement or remission of symptoms for some period of time following the injection. In about 10 to 15% of the cases, the symptoms go away and never come back. Most of the time, however, the symptoms go away for a period of time and then return to some extent. This is frequently several months after the injection.

How are blocks performed?
These procedures take 10-15 minutes to complete and are most safely accomplished under fluoroscopic (x-ray) control so as to increase the accuracy of the block. Patients are typically asked to lie on an x-ray table and the skin is prepped with an antiseptic. Next, the skin is numbed with local anesthetic much the same way a dentist numbs your teeth. The procedure needle is then placed through the numb area to the specified site and its position is check with the x-ray machine. Sometimes, a tiny amount of x-ray dye is used to help confirm the needle placement. Finally, the mixture of steroid and local anesthetic is injected--the actual injection is generally pretty painless, although some will experience a pressure feeling or a temporary increase in pain.

Block procedures performed in this manner require exposure to x-rays. If there is ANY CHANCE that you may be pregnant, inform the technologist and/or your physician. You SHOULD NOT have the procedure done.

Are there any side-effects?
Side effects from the procedures are common, however, serious side effects are extremely uncommon. The more common side effects are an increase in the usual amount of pain or having some new pain which, in the vast majority of patients, will resolve within one to ten days. These reactions are called "flares" and occur in less than one out of ten injections. Adverse reactions usually do not occur and are temporary when they do occur. These include changes in menstrual regularity, headaches, euphoria, depression, swelling, skin rash and weakness or numbness of arms or legs, depending on area of injection. Serious problems such as infection or severe allergic reactions, strokes, or heart attacks can theoretically occur at an incidence of about one in ten thousand injections. Discomfort from the actual procedure is usually minimal, but depends on the specific problem.

Are there different types of blocks?
There are many different types and many different techniques, here is a list of some of the most common ones:

Cervical, thoracic, lumbar, or caudal epidural block — These all involve placing the medications into the epidural space, the space between the bony spinal canal, the spinal discs and spinal cord or nerve sac. The names: cervical, thoracic, lumbar, and caudal, simply refer to the specific region of the spine where the block is placed.

Selective nerve root block — These involve placing the medication on the nerve root at the point where the nerve exits your bony spinal canal through a tunnel known as a neuroforamen. There are two neuroforamen (left and right) at each spinal level.

Facet joint block — These involve placing the medication into the small posterior joints adjacent to your spinal canal, called the zygoapophyseal, or facet joints. There are two facets (left and right) at each spinal level.

Sympathetic block — These involve placing the medication into the sympathetic nerve plexus, which are the nerve centers for specific types of pain impulses and lie immediately adjacent to your spine.

Sacroiliac joint block — These involve placing the medication into your sacroiliac joint on either the left or right and are used for sacroiliac pain syndromes.