Neuraxial Injections

Neuraxial Injections

Neuraxial Injections

Neuraxial Injections

Nerve Block Injections

Looking at neuraxial nerve blocks in Toronto more closely, these are nerve block injection techniques that pertain to the delivery of local anesthetics and medication in the fatty tissue that surrounds the nerve roots existing around the central nervous system.

In general, a neuraxial nerve block will numb or relieve painful sensations from the abdomen to the toes.

At our clinic, we offer our patients three main forms of central neuraxial nerve blocks in Toronto:

  • Spinal, also known as intrathecal or subarachnoid, nerve blocks
  • Epidural, also known as extradural or peridural, nerve blocks
  • Caudal, also known as lumbar-sacral epidural, nerve blocks

Spinal nerve block injections

Spinal nerve blocks are achieved by an injection of local anesthetic agent and medication into the cerebrospinal fluid that surrounds the spinal cord. Along the spinal vertebrae, a spinal nerve block is generally injected at the level of L1/2 which is where the spinal cord ends.

The efficacy of spinal nerve blocks can be determined by factors such as the posture of the patient during and after the procedure, the quality of the nerve block injection and the spread of the medication. The effects of posture on the nerve block will further depend on the type of solution used in the injection.

A spinal nerve block will have the greatest effect on the nervous system in the region where the anesthetic agent was injected. There can also be varying effects on the respiratory cardiac and gastrointestinal systems of the body from the spinal injection, thus it is important that a spinal nerve block is administered with caution.

The procedure itself for a spinal nerve block is fairly quick. It takes approximately 2-5 minutes to administer and can be completed in our clinic in downtown Toronto.

Epidural nerve block injections

An epidural nerve block injection delivers a solution of local anesthetic and anti-inflammatory steroid into the epidural space, which is the space that surrounds the spinal cord. The exact location for the administration of an epidural nerve block is determined by a number of factors, including:

  • The weight of the medication
  • The volume of the solution being injected
  • The age of the patient
  • Pressure of the abdomen
  • Position of the patient
  • Technique used to perform an epidural injection

An epidural nerve block can be used for several indications including acute pain relief, caused by post-operation or trauma and chronic pain relief, as seen in cancer patients.

Caudal nerve block injections

Compared to the other techniques for a neuraxial injection, a caudal nerve block is more limited to the administration of anesthetic and steroid for pain relief to the nerves of the lower body, especially the lumbar and sacral nerves. This limitation however, does offer the benefit of specificity. A caudal nerve block does not cause systemic side effects on other organ systems. Instead, this type of injection can lead to problems with normal bowel and bladder function.

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How is a neuraxial injection performed?

A neuraxial injection is performed by inserting a thin needle containing the anesthetic and steroid between the vertebrae and injecting the contents either into the epidural space or subarachnoid space.

The procedure for a neuraxial injection is performed under local anesthesia at the site of injection. Patients experience very little to no discomfort with these injections.

How to prepare for a neuraxial injection

While planning the Toronto neuraxial nerve block procedure, our medical team will ensure that they have a comprehensive discussion with the patient prior to the procedure. This conversation will provide all the necessary information for an effective and smooth neuraxial injection procedure.

Sometimes, we may ask our patients to perform some simple diagnostic tests prior to the neuraxial injection, such as a blood test and certain scans. This is to determine if a neuraxial nerve block is the appropriate treatment for their chronic pain.

Patients who appear to be nervous or tense about the procedure may be recommended to take some sedative medication to help relax. However, it is not always needed and we do avoid the use of heavy sedation for this procedure.

Finally, patients who are preparing for a neuraxial nerve block injection are asked to restrict their intake of fluids and food. This is because procedures such as these will have the risk of nausea and regurgitation of food.

At our clinic, a neuraxial nerve block is performed as a short, outpatient surgical procedure.

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What to expect during and after a Toronto neuraxial nerve block

During the injection of the neuraxial nerve block, patients often experience a stinging sensation due to the insertion of the thin needle into the appropriate region of the spine.

As the medications are injected, patients may experience a change in sensation at the site of injection. These sensations include pressure, tissue tension and temperature alterations. These are completely expected and normal as long as correct technique was used for the injection.
After the procedure, we will test the efficacy of the neuraxial nerve block injection by performing an examination on the nervous system in the treated area.

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The associated risks of neuraxial nerve block injections

As with any medical procedure, there are complications and risks associated with a neuraxial nerve block injection, including the following:

  • Nerve damage
  • Excessive bleeding
  • Infection
  • Systemic toxicity of medication, which can lead to dizziness, tinnitus, blurred vision, numbness, tremors, sedation, seizures, arrhythmias and decreased blood pressure
  • Headache
  • Failure to achieve therapeutic efficacy

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Go Painless

Our team at Painless Medicine and Therapeutics focuses on improving our patient’s pain conditions.

Our goal and philosophy is to make the patient’s therapeutic experience as painless as possible by finding a therapeutic plan that best treats their symptoms and lifestyle. We truly believe in collaboration and working closely with patients so that they have control over their medication, and so that the treatment aligns with our clinic’s values.

In cases where chronic pain cannot be cured, but instead must be effectively managed, our team’s purpose is to limit the complications and to minimize the severity of the symptoms experienced by the patient. We wish to optimize our patients’ control over their pain so they feel enabled to be the best possible version of themselves and enjoy life again.

If you are suffering from a chronic pain condition, we highly suggest that you visit our clinic in Toronto to see what we can do for you.