Why transforaminal and not SNRB?

[SteveE]

Pain Doc please reply. Thank you for your reply to my question about the difference between these injections. I'm now confused. After my spine doc said I have a nerve compression at L45, I said wouldn't it be a good idea to do a SNRB to confirm that this is the nerve root causing my pain? He agreed but I'm told by his assistant that he wants to do a transforaminal epidural injection at L45. According to what you said, this injection is done for therapeutic purposes when the nerve root causing the pain has been confirmed. We have not confirmed the pain generator. Am I missing something? Do you know why he wants to do the transforaminal instead of the SNRB? Any suggestions how I can further discuss this with the spine doc so I don't irritate him. Thanks for your help. Steve

[Blairsara]

An epidural injection is a nerve block to help alleviate the pain. Doesnt make sense that if you dont know where the pain is coming from that he would want you to have that procedure. Usually there is a procedure done to pinpoint exactly where the pain is coming from. I'm not a doctor or a pain specialist, but from all of my various procedures I do know that. I would definitely talk to your doctor before having this procedure, because why go through it if that isnt the cause of your pain.

[paindoc]

SteveE-Sorry it has taken me so long to get back to you, but I did not know you had further questions. Mark usually cotacts me if there is a question, but this one I'm sure just flew under the radar. With the info you gave, I'll do my best...first, many interventionalists don't know the difference between the two blocks much less an assistant in his office. For all you know, he wanted a SNRB, but because the terms are used so interchangably even in the field, it is hard to say what was desired or performed. Also, if your physical exam and radiographic findings are consistant with a problem at L4-5, there may be no need to do a SNRB...your doctor may be confident anatomically, and a TF would be appropriate and save you a block. The best idea is to just get a clairification from your doc. Good luck

[Maria]

Steve,
Per discogram I'm concordant for pain at L4 and L5S1. I've an anular tear at L3 (non concordant for pain on discogram) and disc bulge at L4/L5S1, scar tissue encasing left S1 nerve root.

I've had a SNRB which did little altho my symptoms weren't so much of leg pain vs. low back pain, and ESIs performed various ways w/TF being of best relief for my particular spinal scenario.

Perhaps you should try this and see if it's helpful. To me the main point is relief~

there are some very helpful websites re these procedures. Check out www.espineinstitute.com [url]www.spine-health.com and also www.chirogeek.com has great spinal tutorial information that may be helpful.

Good luck either way with pain relief