Abstract
Background
Acute lumbar radiculopathy is a very painful condition sometimes requiring admission for strong analgesia.
Purpose
To evaluate the efficacy of distal nerve root blocks as an outpatient procedure for immediate pain relief.
Methods
Local anaesthetic was injected in the distal nerve root areas of the leg and foot in the clinic in patients with lumbar radiculopathy who consented to the procedure.
Results
There were 29 patients, 18 females and 11 males, aged 25 to 76 years. 13 patients had acute lumbar disc prolapse, 11 had lumbar canal stenosis, 2 had annular tears and one a facet joint cyst. The VAS pain scores ranged from 3 to 11 (patient's description), with an average VAS score of 7.5. The improvement in VAS scores was between 2 and 9 with average improvement of 6. 19 patients had associated back pain which improved in 14. Walking improved in all 29 patients.
Pain relief was immediate in all patients. This lasted from 30 min to 11 days with one patient having no recurrence. 27 patients had at least 24 hours pain relief. All patients could be sent home immediately after the procedure.
12 patients had recent onset of foot weakness which improved one MRC grade immediately after the injection. The analgesic effect was most significant in acute disc prolapse.
There were no complications.
Conclusion
This technique is simple and would be valuable in the acute setting to provide immediate pain relief allowing immediate discharge from accident and emergency.
Conflicts of interest: None
Sources of funding: None
