Concierge pain medicine · London
Private nerve root block in London, image-guided, by a consultant.
A precise, image-guided selective nerve root block for sciatica or radicular arm pain - diagnostic and therapeutic, delivered by a consultant pain physician using the safer non-particulate steroid.
Why patients choose us
- 01
A consultant pain physician, image-guided
A named interventional pain consultant or radiologist, in a fluoroscopy or CT suite - not a blind injection in a treatment room.
- 02
Dexamethasone preferred over particulate steroid
Following SIS and BSIPP safety guidance, we default to non-particulate steroid to reduce the rare risk of spinal cord infarct.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private nerve root block costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A single-level fluoroscopy-guided block in our network: £600–£1,400, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Single-level nerve root block (fluoroscopy) | £600–£1,400 | 15–30 min | Same visit |
| Additional level, same session | £250–£500 | 10–15 min | Same visit |
| CT-guided nerve root block (specialist) | £900–£1,800 | 30–45 min | Same visit |
| Cervical nerve root block | £800–£1,600 | 20–30 min | Same visit |
| Sedation add-on (anaesthetist) | £300–£600 | Half-day | Same visit |
| Pain consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by whether fluoroscopy or CT is used, by the level and side treated, and by whether additional roots are injected in the same session. Facility and imaging fees are included in the range above. We come back with a firm quote within one working day.
The problem
The right level, the right guidance, the right steroid.
Nerve root blocks are quietly one of the most variably delivered spinal injections in the private market - blind technique, particulate steroid, or the wrong level. We fix all three before you commit.
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Not sure it will help?
A block is only worth doing if your pain is truly radicular. If it is axial back pain, we say so before you agree to the injection.
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Worried about safety?
Image guidance with contrast and non-particulate steroid dramatically reduce the rare serious risks - we insist on both.
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Considering surgery?
A diagnostic block confirms the exact root causing your pain, so a discectomy, laminectomy or foraminotomy is aimed at the right target.
The journey
From enquiry to review - what happens, in order.
One clinician from first message to review - including the two-week pain diary that tells you whether the block truly worked.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A couple of hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Leg or arm pain pattern, MRI findings if you have them, medications, blood thinners.
- 02
Before
We come back with a recommendation
Within one working day: the right level, the right guidance (fluoroscopy or CT), and an indicative price. If a block is not the right step, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Anticoagulation is reviewed per BSIPP guidance and you are told exactly how to prepare.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the pain physician. Local anaesthetic, with light sedation if you prefer.
- 05
On the day
The injection itself
15 to 30 minutes in an image-guided suite. Contrast confirms safe spread before the anaesthetic and steroid go in.
- 06
On the day
Home the same day
A short recovery, written aftercare, and home within a couple of hours. If sedation was used you will need someone to collect you.
- 07
After
Diary, physio and review
You keep a simple pain diary for two weeks. Physio restarts as pain allows. A review confirms whether the root is the pain generator.
Typical end-to-end: 1–2 weeks from enquiry to injection. Diary and review: 2–4 weeks after.
When it helps
When a nerve root block is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Lumbar radiculopathy (sciatica)
Leg pain in a single dermatome from a disc prolapse or foraminal stenosis - the classic indication.
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Cervical radiculopathy
Arm pain, numbness or weakness from a compressed cervical nerve root - often C6 or C7.
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Foraminal or lateral recess stenosis
A narrowed exit for the nerve root - a targeted injection often outperforms an interlaminar epidural here.
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Surgical planning
Diagnostic block to confirm the exact root causing pain before targeted decompression - discectomy, laminectomy or foraminotomy.
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Failed back surgery syndrome
Residual or adjacent-segment radiculopathy after previous spine surgery - a selective block can pinpoint the culprit.
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Bridge to physio recovery
Pain relief that lets you engage with physiotherapy properly, and often avoid surgery altogether.
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Multi-level disease
Two or three roots can be injected in one session when the imaging and symptoms warrant it.
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Red flag: cauda equina
Saddle numbness, new bladder or bowel changes, or bilateral leg weakness is an emergency - same-day A&E, not a clinic booking.
Block options
A selective block is not the only option.
What each option on the table actually involves - and which fits which problem.
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Fluoroscopy-guided SNRB
The standard image-guided approach - live X-ray plus contrast confirms safe epidural and foraminal spread before injection.
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CT-guided SNRB
Cross-sectional guidance for complex anatomy, revision cases, or where fluoroscopy is unsuitable - performed by an interventional radiologist.
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Cervical nerve root block
Targeted injection at C4–C8 for arm pain and cervical radiculopathy - done seated or prone under fluoroscopy.
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Lumbar nerve root block
The commonest form - prone, fluoroscopy-guided, targeting L3–S1 for sciatica and single-dermatome leg pain.
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Diagnostic-only block
Local anaesthetic alone, no steroid - used to confirm the pain generator before decompression surgery.
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Multi-level block, one session
Two or three roots treated in the same visit when the imaging and dermatomal pattern support it.
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Non-particulate (dexamethasone)
The preferred steroid per SIS and BSIPP safety guidance - reduces the rare risk of spinal cord infarct from intra-arterial injection.
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Consultation only
An honest discussion of whether an injection is the right step, or whether surgery, physio or medication is the better route.
Our vetted London network
A small panel of pain physicians, we picked them.
Consultant interventional pain physicians and radiologists across central, north, west and south London. Not listed publicly - introductions are made privately, once we understand your case.
Selection criteria
How we choose every pain physician in our network.
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Consultant pain physicians and interventional radiologists, not trainees
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Fluoroscopy or CT guidance for every injection - no blind technique
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Non-particulate steroid (dexamethasone) as the default choice
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BSIPP-aligned anticoagulation and safety protocols
Safety and recovery
What to expect afterwards - honestly.
A nerve root block is a common, safe day-case pain intervention when it is image-guided and done with non-particulate steroid. The things worth planning are transport home, your pain diary, and knowing what is normal after.
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Image guidance is not optional
Fluoroscopy or CT with contrast is what makes this safe. Contrast confirms epidural spread and rules out intravascular placement before any drug goes in.
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Dexamethasone over particulate steroid
Rare but catastrophic spinal cord infarction has been reported with particulate steroids in the cervical and upper lumbar spine. Non-particulate is our default.
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Transient leg or arm changes
Numbness, heaviness or weakness in the dermatome for four to six hours after the local anaesthetic is expected. Do not drive home.
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Anticoagulation is reviewed
Warfarin, DOACs and antiplatelets are managed per BSIPP guidance - never stopped without a plan, to balance bleeding and clot risk.
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Steroid side effects
Transient facial flushing, insomnia and a short spike in blood sugar are common. Diabetic patients monitor glucose for a few days.
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Repeat injections have a ceiling
Up to three steroid injections per year is the usual limit to keep total steroid exposure and adrenal-suppression risk low.
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Pain diary matters
A simple two-week diary tells us whether the root is the true pain generator - vital if surgery is being considered.
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Not everyone responds
Around 60–80% of well-selected patients get meaningful relief. If the pain is not inflammatory or the root is not the source, the block will not work.
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Red flags after the procedure
Severe headache, fever, spreading weakness, or new bladder or bowel symptoms are not normal - call the clinic or A&E the same day.
Reading your procedure note
Your procedure note in four parts. Read the last one first.
Whichever level was treated, the note the pain physician sends you keeps to the same shape.
A quiet reminder
Procedure language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Level, side and indication
Which nerve root was targeted, which side, and why - sciatica, cervical radiculopathy, diagnostic for surgical planning.
- 02 Technique
Guidance, needle path and contrast
Fluoroscopy or CT, the needle approach used, and confirmation of correct epidural and foraminal contrast spread.
- 03 Findings
Drugs given and immediate response
The local anaesthetic and steroid used (dose and type - usually dexamethasone), and any immediate change in pain in recovery.
- 04 Impression
Diary, physio plan and review
Read this first: what to expect over two weeks, when to restart physio, and whether a repeat block or surgical opinion is planned.
Recognised by major UK insurers
Cover for nerve root blocks varies by insurer and by indication - usually funded when medically indicated and MRI-supported, subject to pre-authorisation. We confirm cover before booking.
Frequently asked
Everything we get asked about nerve root blocks.
Quick answers on pain, cost, safety, steroid choice, and whether a block means you avoid surgery.
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What is a nerve root block and how is it different from an epidural?
A selective nerve root block (SNRB), also called a transforaminal epidural steroid injection, targets one specific spinal nerve root through the foramen where it exits the spine. A standard interlaminar or caudal epidural bathes several roots at once. Selective blocks are more precise and are both diagnostic and therapeutic.
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What conditions is it used for?
Radicular pain - sciatica in the leg or radicular arm pain - from disc prolapse, foraminal stenosis or lateral recess stenosis where the symptoms match a single dermatome. It is also used diagnostically before spine surgery to confirm the root causing the pain, and for residual pain after previous surgery.
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Does the injection hurt?
The skin is numbed with local anaesthetic, and the injection itself is usually described as pressure rather than sharp pain. Some patients feel a brief reproduction of their usual leg or arm pain as the needle reaches the root - this is expected and settles quickly.
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How much does a private nerve root block cost in the UK?
Roughly £600–£1,400 per level under fluoroscopy at a private London clinic, or £900–£1,800 for CT-guided injections. Additional levels in the same session are usually £250–£500 each. Sedation, if you want it, adds £300–£600.
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How well does it work and how long does it last?
In well-selected patients with true radicular pain, around 60–80% get meaningful pain relief. The effect typically lasts three to six months, sometimes longer, and the injection can be repeated up to three times a year if it helps.
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Is it safe? What are the risks?
Serious complications are very rare (well under 1 in 10,000) when image guidance and non-particulate steroid are used. Common short-lived effects include transient weakness or numbness in the leg or arm, a brief pain flare, facial flushing, insomnia and a temporary rise in blood sugar. The rare serious risks are spinal cord infarct, epidural haematoma, dural puncture and infection.
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Why do you prefer dexamethasone over methylprednisolone?
Rare cases of spinal cord infarction have been reported when particulate steroids (methylprednisolone, triamcinolone) are inadvertently injected into a radiculomedullary artery, particularly in the cervical and upper lumbar spine. Non-particulate dexamethasone effectively eliminates this specific mechanism of harm - this follows SIS 2014 guidance and current BSIPP practice.
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Will I still need surgery?
Sometimes a successful block gives lasting relief and you avoid surgery altogether. Other times the block confirms the root as the pain generator and helps the surgeon plan a targeted decompression - a discectomy, laminectomy or foraminotomy - with more confidence. Either way, the block is useful information.
Related treatments
Looking for something else?
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Epidural steroid injection
Interlaminar or caudal epidural for broader spinal pain relief.
Learn more -
Discectomy
Targeted removal of a disc fragment compressing a nerve root.
Learn more -
Laminectomy
Decompression surgery for spinal stenosis and nerve root compression.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more