Selective Nerve Root Block (SNRB) in the Cervical Spine

A Selective Nerve Root Block (SNRB) in the cervical spine is a precise, image-guided injection used to both diagnose and treat neck, shoulder, and arm pain caused by irritation or compression of a specific spinal nerve. By delivering a small amount of anesthetic and steroid medication around the affected nerve root, this procedure can reduce inflammation, relieve pain, and help determine the exact source of nerve-related symptoms.

Quick Facts

  • Setting: Outpatient, image-guided
  • Time: ~20–30 minutes
  • Anesthesia: Local with optional light sedation
  • Recovery: Same-day discharge; mild soreness possible for 1–2 days
  • Purpose: Diagnostic and therapeutic for cervical nerve irritation

Who It Helps

  • Cervical disc herniation or bulging disc
  • Foraminal stenosis or narrowing of nerve pathways
  • Radiculopathy (pain radiating from the neck into the shoulder or arm)
  • Nerve compression from arthritis or degenerative changes
  • Patients being evaluated for surgical or interventional options

How It Works

Each spinal nerve exits the spinal canal through a small opening called a foramen. When this nerve becomes irritated by a herniated disc or bone spur, it can cause sharp, radiating pain. During an SNRB, your provider uses fluoroscopic (X-ray) guidance to precisely place a thin needle near the affected nerve root. A small amount of anesthetic is injected to temporarily numb the nerve, and a corticosteroid may be added to reduce inflammation and swelling. The immediate pain response helps confirm whether that nerve is the source of your symptoms.

What To Expect

  • Before: Your provider will review your imaging and medical history to identify the target nerve. You may be asked to stop certain medications before the procedure.
  • During: You’ll lie comfortably on your stomach or side. After numbing the skin, a small needle is guided under X-ray to the specific nerve root. Once positioned, medication is injected around the nerve.
  • After: You’ll rest briefly in recovery before going home. Some temporary numbness or weakness may occur, followed by gradual improvement as inflammation decreases over the next few days.

Benefits & Risks

Benefits:

  • Pinpoints the exact nerve causing pain
  • Provides targeted relief for radiating neck, shoulder, or arm pain
  • Minimally invasive, outpatient procedure
  • Helps guide further treatment decisions (surgical or nonsurgical)

Risks:

  • Temporary soreness or numbness
  • Infection, bleeding, or headache (rare)
  • Allergic reaction to medication (rare)
  • Temporary increase in pain before improvement

Is It Right For Me? (Checklist)

  • ✅ Neck and arm pain caused by nerve irritation or compression
  • ✅ Diagnostic confirmation of nerve-related symptoms needed
  • ✅ Failed to improve with physical therapy or medication
  • ✅ Comfortable with an image-guided outpatient procedure

Alternatives At PCET

FAQs

  • When will I notice relief? Relief may occur within a few days as inflammation subsides.
  • How long does relief last? Results vary; relief may last weeks to months depending on the condition.
  • Is this mainly diagnostic or therapeutic? It can serve both purposes—identifying the painful nerve and reducing inflammation.
  • Is it painful? Most patients feel only mild pressure; local anesthetic minimizes discomfort.
  • Is it covered by insurance? Most insurance plans, including Medicare, cover SNRBs when medically necessary.

What Happens Next?

After a Cervical Selective Nerve Root Block, your provider will review how your pain responds and whether you notice improvement in neck, shoulder, arm, or hand symptoms.

If you experience meaningful relief, your provider may use that response to better understand which nerve may be contributing to your pain and discuss the next step in treatment.

If you do not get the relief you were hoping for, that does not mean you are out of options. Your provider may reassess whether your symptoms are coming from another source or whether a different treatment path may be more appropriate.

Possible next steps may include:

  • Reviewing your symptoms and imaging again
  • Evaluating other possible pain sources
  • Additional diagnostic testing when appropriate
  • A different injection or procedure
  • Physical therapy or functional rehabilitation
  • Other treatment options available through PCET

The goal is to better understand your pain, identify the most likely source, and determine the next best step for your care.

📞 Call to Schedule

If you’re experiencing radiating neck, shoulder, or arm pain caused by nerve irritation, a Selective Nerve Root Block may help identify and relieve the source of your pain. Call us at 865-934-2567 to schedule your appointment today.