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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.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private nerve root block costs in London.

Indicative ranges across UK private providers.

In short

£600–£1,400, home the same day.

Procedure Indicative range
Single-level nerve root block (fluoroscopy) £600–£1,400
Additional level, same session £250–£500
CT-guided nerve root block (specialist) £900–£1,800
Cervical nerve root block £800–£1,600
Sedation add-on (anaesthetist) £300–£600
Pain consultation only £200–£400

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.

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. All three are worth checking before you commit.

  • Not sure it will help?

    A block is only worth doing if your pain is truly radicular. If it is axial back pain, a block is unlikely to help, so ask before you agree to the injection.

  • Worried about safety?

    Image guidance with contrast and non-particulate steroid dramatically reduce the rare serious risks - both are worth asking for.

  • Considering surgery?

    A diagnostic block confirms the exact root causing your pain, so a discectomy, laminectomy or foraminotomy is aimed at the right target.

When it helps

When a nerve root block is the right step.

The situations most often seen, plus the one red flag that means an emergency rather than an appointment.

  • Lumbar radiculopathy (sciatica)

    Leg pain in a single dermatome from a disc prolapse or foraminal stenosis - the classic indication.

  • Cervical radiculopathy

    Arm pain, numbness or weakness from a compressed cervical nerve root - often C6 or C7.

  • Foraminal or lateral recess stenosis

    A narrowed exit for the nerve root - a targeted injection often outperforms an interlaminar epidural here.

  • Surgical planning

    Diagnostic block to confirm the exact root causing pain before targeted decompression - discectomy, laminectomy or foraminotomy.

  • Failed back surgery syndrome

    Residual or adjacent-segment radiculopathy after previous spine surgery - a selective block can pinpoint the culprit.

  • Bridge to physio recovery

    Pain relief that lets you engage with physiotherapy properly, and often avoid surgery altogether.

  • Multi-level disease

    Two or three roots can be injected in one session when the imaging and symptoms warrant it.

  • 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.

  • Fluoroscopy-guided SNRB

    The standard image-guided approach - live X-ray plus contrast confirms safe epidural and foraminal spread before injection.

  • CT-guided SNRB

    Cross-sectional guidance for complex anatomy, revision cases, or where fluoroscopy is unsuitable - performed by an interventional radiologist.

  • Cervical nerve root block

    Targeted injection at C4–C8 for arm pain and cervical radiculopathy - done seated or prone under fluoroscopy.

  • Lumbar nerve root block

    The commonest form - prone, fluoroscopy-guided, targeting L3–S1 for sciatica and single-dermatome leg pain.

  • Diagnostic-only block

    Local anaesthetic alone, no steroid - used to confirm the pain generator before decompression surgery.

  • Multi-level block, one session

    Two or three roots treated in the same visit when the imaging and dermatomal pattern support it.

  • Non-particulate (dexamethasone)

    The preferred steroid per SIS and BSIPP safety guidance - reduces the rare risk of spinal cord infarct from intra-arterial injection.

  • Consultation only

    An honest discussion of whether an injection is the right step, or whether surgery, physio or medication is the better route.

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.

  • 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.

  • 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 steroid is the usual default.

  • 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.

  • Anticoagulation is reviewed

    Warfarin, DOACs and antiplatelets are managed per BSIPP guidance - never stopped without a plan, to balance bleeding and clot risk.

  • Steroid side effects

    Transient facial flushing, insomnia and a short spike in blood sugar are common. Diabetic patients monitor glucose for a few days.

  • 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.

  • Pain diary matters

    A simple two-week diary shows whether the root is the true pain generator - vital if surgery is being considered.

  • 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.

  • 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 UK consultant pain physician reviewing a patient’s procedure notes

A quiet reminder

Procedure language is precise and can read coldly - ask your care team to explain anything that is unclear.

If you would like someone to talk you through the note before your review, ask the clinician who wrote it.

  1. 01 Header

    Level, side and indication

    Which nerve root was targeted, which side, and why - sciatica, cervical radiculopathy, diagnostic for surgical planning.

  2. 02 Technique

    Guidance, needle path and contrast

    Fluoroscopy or CT, the needle approach used, and confirmation of correct epidural and foraminal contrast spread.

  3. 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.

  4. 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

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for nerve root blocks varies by insurer and by indication - usually funded when medically indicated and MRI-supported, subject to pre-authorisation.

Frequently asked

Common questions about nerve root blocks.

Quick answers on pain, cost, safety, steroid choice, and whether a block means you avoid surgery.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

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