Periradicular therapy - Frequently asked questions

What is periradicular therapy

Periradicular therapy is a recognised and very reliable method of minimally-invasive spine pain therapy for treating radicular pain syndromes (pains which are caused by irritation of the nerve root).

When should periradicular therapy be performed?

PRT is a local pain therapy and should be used in the case of pain syndromes which are definitely caused by the irritation of a nerve root.

These include:

  • Compression of a nerve root by a slipped disc
  • Compression of a nerve root by a narrowing of the nerve exit holes (neuroforaminal stenoses)
  • Irritation of the nerve root caused by scar tissue which developed after an operation.

What must be borne in mind before periradicular therapy

Medicines which thin the blood (ASS, Aspirin, Heparin) must be discontinued for c. 7 days before the examination.

MR arthrography may only be performed on patients undergoing marcumar therapy after they have switched to heparin or have a Quick value of >50%.

How does PRT work?

In order to treat the pain specifically at the nerve root, a special (extremely thin) needle is placed, under screen control, in the immediate vicinity of the nerve root. Another CT scan of the area is used to ensure that the needle is in the correct position. Only when the needle is in the correct position are Bucain (0.25%) and Volon A administered.

Bucain 0.25% (active ingredient Bupivacain 0.25%) is a local analgesic which has for years been used routinely to treat acute pain.

Volon A (active ingredient Triamcinolon) is a cortisone preparation which is fixed to extremely small crystals for the purpose of long-term anti-inflammatory therapy.
The pharmacological structure of the medicine ensures that it has a great local effect at the location of the injection with minimal systemic side-effects.

How long is periradicular therapy effective?

Sometimes sustainable success can be achieved after one injection, sometimes the therapy must be repeated at intervals of 3-4 weeks.

How often can periradicular therapy (PRT) be performed?

The frequency of PRT is dictated primarily by its success. If a patient is free of pain after the first injection, no further injections are made.

If the therapy does not prove to be successful in the long term, PRT should not be performed more than 5-6 times.

What must be borne in mind after PRT?

After PRT has been performed, the patient can resume their usual activities.