NeuroTalk Support Groups - Can a nerve root block distinguish between locally generated pain and nerve root?

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Can a nerve root block distinguish between locally generated pain and nerve root?

So for 12 months I have had excruciating pain in my right foot. MRIs showed there was nothing wrong with the foot itself - my GP then thought it might be a peripheral neuropathy but seeing as the main causes of this are diabetes and alcoholism and I don't have either then this is unlikely . I then saw a pain specialist who said that the cause was in my back as a lumbar MRI showed an L5 S1 disc herniation. I had a series of four nerve blocks/ steroid injections into L5 S1 and three of these relieved the foot pain completely ( temporarily). It came back and last week I had a discectomy on L5S1 but this has done nothing for the foot pain - it is still there as strong as ever. My question is : were they on the right track saying the source was in the nerve root ( as evidenced by the success of the nerve blocks) or could this pain have a local cause in the foot itself ??
I have never heard of anyone getting peripheral neuropathy in just one foot have you ?
Does the success of the nerve root blocks 100% confirm that the cause is in the nerve root or could a nerve root block stop pain that has a source elsewhere ???
I am very confused as to what the success of a nerve root block actually shows ??
Thoughts please !
Many thanks.

Quote:

Originally Posted by Paininfoot (Post 1148056)

Frustrating, I know. Successful ESI in your case strongly suggest root problems so that combined with a positive MRI and favorable blocks make a discectomy a reasonable consideration. A lesser thought would be post-surgical CRPS. Diabetic neuropathy should be evident with proper lab evaluation. Might want to check in with an endocrinologist to complete your work-up. Since you have no surgical resolution, a follow-up MRI with contrast looking to differentiate between recurrent disc hernia vs. scar tissue would be prudent. Perhaps even repeat EMG/NCV and even add SSEP's. Good luck!

Yes, unilateral symptoms can be related to spinal nerve roots, especially if the pathology affecting the nerve root is asymmetric or not bilateral.

It takes time for nerves to heal and there is also the possibility it's too damaged to recover. What did your post op notes say? Did they see compression?

Also, make sure they haven't overlooked any cysts in the area. Surgeons are classically trained to ignore them but they can be problematic too.