Dorsal root ganglion block / Transforaminal epidural / Nerve root block
A precision injection placed at the exit point of a specific spinal nerve — used both to diagnose which nerve root is driving your radicular pain and to deliver targeted anti-inflammatory relief.
Led by Dr Arul James (Consultant in Pain Medicine, GMC Specialist Register) at The Vesey, Sutton Coldfield. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). Same-week appointments typical.
Who this procedure is for
- Radicular limb pain (sciatica, cervical radiculopathy) where imaging shows multi-level disease and the pain-generating root needs to be identified.
- Failed conservative management of single-level radiculopathy where targeted relief can defer or avoid surgery.
- Post-surgical persistent radicular pain after lumbar or cervical decompression.
- Pre-surgical planning where a positive diagnostic block confirms the surgical target.
How the procedure is performed
Fluoroscopy-guided placement of a fine needle into the foramen at the targeted level. Contrast confirms correct epidural / perineural spread, then local anaesthetic and a small dose of steroid are delivered onto the dorsal root ganglion. Procedure time 20–30 minutes; visit 60–90 minutes including recovery.
Before, during and after
- Before: light meal allowed. Continue most regular medications; we will confirm anticoagulant plan at consent. Bring your most recent MRI.
- During: prone, awake, with local anaesthetic to the skin. You may feel a brief reproduction of your typical pain — this confirms a correctly-targeted block.
- After: 30 minutes of monitored recovery. Diagnostic relief is immediate; therapeutic effect from the steroid develops over a week.
Recovery and aftercare
No driving for 24 hours. Light activity from the same evening, back to office work next day, restart physiotherapy at 48–72 hours. Therapeutic benefit typically lasts 3–6 months when the block is treating root inflammation that is itself improving.
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Risks and side effects
Common: brief site soreness, transient leg or arm heaviness if local anaesthetic spreads. Uncommon: dural puncture headache (< 1%), transient nerve irritation. Rare: bleeding, infection, allergic reaction, neurological injury. Very rare but reported in cervical procedures: spinal cord injury (minimised with image guidance and digital subtraction angiography).
When this procedure is not appropriate
Pregnancy, active local infection, uncorrectable bleeding disorder, severe contrast allergy without alternative, clear surgical indication (e.g. cauda equina, progressive motor weakness — we refer urgently).
Cost and pathway
Initial consultation £260. Image-guided transforaminal / dorsal root ganglion block from £950 (single level) including consent, image guidance, drugs, recovery and written report.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with Dr Arul James
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
View the full pain management pathway →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727