Selective Nerve Root Injections in Houston Book Visit

Selective Nerve Root InjectionsTransforaminal selective nerve root blocks to pinpoint which spinal nerve is generating your pain and to reduce inflammation around it — performed under fluoroscopy by board-certified pain management physicians at Remix Medical in Houston, TX.

Specialty: Pain Management
Type: Procedure
Body location: Cervical nerve roots, thoracic nerve roots, lumbar nerve roots, neural foramen, dorsal root ganglion
CPT code: 64479 (transforaminal, cervical/thoracic, single level), 64480 (each additional level); 64483 (transforaminal, lumbar/sacral, single level), 64484 (each additional level); 77003 (fluoroscopic guidance, when reported separately)

Also known as: Selective Nerve Root Injection, SNRB, Transforaminal Injection, Nerve Root Block, Transforaminal Epidural Steroid Injection

Selective Nerve Root Block in Houston, Texas

An MRI of a degenerating spine often shows several levels that could plausibly be causing pain. Surgery based on that ambiguity is a gamble. A selective nerve root block resolves it by anesthetizing one nerve root at a time and asking a simple question: did your pain stop?

What is a Selective Nerve Root Injection?

A selective nerve root block — also called a transforaminal injection — delivers a very small volume of local anesthetic, usually with corticosteroid, directly onto a single spinal nerve root as it exits the spine through its foramen.

The deliberately small volume is what makes it selective. Larger volumes spread to adjacent levels and destroy the diagnostic value.

Two Jobs at Once

Diagnostic. When imaging implicates multiple levels, or when the pain pattern does not match the imaging, blocking one root at a time identifies which one is symptomatic. This directly informs whether and where to operate.

Therapeutic. The corticosteroid reduces inflammation around the root, and many patients get durable relief without ever proceeding to surgery.

Who It Helps

Radiculopathy from a herniated or bulging disc, with pain following a nerve distribution
Foraminal stenosis narrowing the exit of a specific nerve root
Multi-level degenerative disease where the symptomatic level is unclear
Sciatica unresponsive to conservative treatment
Post-surgical radicular pain at an adjacent or recurrent level
Pre-surgical planning , to confirm the target before committing to decompression

Precision Before Intervention at Remix Medical

The most important thing a pain physician can give you is an accurate diagnosis. Everything downstream depends on it. Contact Remix Medical to schedule a consultation with a board-certified pain management physician in Houston.

How it's performed

Under live fluoroscopic guidance, a needle is advanced toward the neural foramen at the target level until it lies adjacent to the exiting nerve root. Contrast is injected to confirm the characteristic outline of the nerve root and to exclude vascular uptake. A small, deliberately limited volume of local anesthetic and corticosteroid is then deposited onto that single root.

How to prepare

Avoid pain medication immediately beforehand, as it can obscure the diagnostic result. Arrange a driver. Hold anticoagulants only as directed by the prescribing physician. Bring recent MRI or CT imaging. Be prepared to record pain scores for several hours afterward.

What to expect after

Record pain scores hourly for 6 to 8 hours — the anesthetic phase carries the diagnostic information. Ice the site 20 minutes every 2 to 3 hours on the first day. Avoid heavy lifting and driving for 24 hours. Temporary numbness or heaviness in the limb is expected and resolves. Report fever, severe headache, or progressive weakness immediately.

Outcome

Substantial relief of familiar radicular pain during the anesthetic phase identifies the symptomatic nerve root with high confidence. The corticosteroid component frequently provides weeks to months of relief, and in many patients avoids the need for surgical decompression.

Learn more

Conditions treated

Sciatica Herniated Disc Spinal Stenosis Bulging Disc Post-Laminectomy Syndrome (FBSS)

Your physician

Your pain management at Remix Medical.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

Raju Mantena, DO
Pain Medicine Physician
Medical Center — South Freeway · Montrose — Upper Kirby · Pearland
Board certifiedAccepting newBook

This page is for general education and is not a substitute for medical advice. Whether a given procedure is appropriate depends on your individual evaluation. Contact a Remix Medical clinician to discuss your care.

Updated July 9, 2026.

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