Pelvic Pain Support Network
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Local and or Steroid Root Nerve Block

I have S2, S3 root nerve blocks planned with Dr Baranowski in mid March. His aim is to block my middle cluneal nerve. I am very keen to have local anaesthetic only and not have the steroid. Dr B will do this, but strongly recommends that I have both. What are your thoughts? My aim at this stage is purely diagnosis. Also, if anyone is knowledgable about these things, wouldn't other nerves be effected by RNBs at S2 and S3? Many thanks for any feedback you might have.

9 Replies

Hello Jeremy 1969

My advice as with any procedure is listen to the surgeon. Hopefully he is familiar with this and is best one to help.

Ask him all your questions which should aliviate any fears.



I totally agree with you, totally. Why put steroids in your body unless absolutely necessary. The anaesthetic will give an indication whether the right spot has been hit. Of course, if the numbing agent does work then you will have to have the procedure done once again.



I've had many diff types of steroid blocks and currently get perineal nerve blocks every 8-10 weeks. Steroids aren't good for you but 1-2 injections aren't going to do any damage. They only use about 40mg at one time which won't do anything. It's continued use that's the problem. however with that said, if this is for diagnostic then from my experience you'll know if the injections work just using the anaestecic alone. The steroid takes 5-7 days to kick in whereas the anaestecic works right away but wears off within an hour or so depending how much you get. As with any doctor, be your own best advocate, make sure they have done loads (100's) of these injections before and are very experienced, ask lots of questions and if it all feels good to you then I usually do go with the Doc says.




If you aren't bothered, would you be so kind as to tell me your experience with perineal blocks, and if/how they help you?


Hi there,

I thought it responded ?

But yes I do think the perineal blocks help, maybe 25%. So I can sit through breakfast, dinner and 5 min drive which I couldn't do before. However, the blocks don't last very long. Some relief better than none 😊

Take care


I know it is not the same block, but the Nantes team do not use the steroid, they say it does not help. Other people seem to have had irritation and more pain as a result of the steroid. Not sure what the medical evidence is when comparing the two. Also Dr s are not totally trustworthy, I have now learnt to ask about all the risks involved with a procedure and if necessary I would ask for the drug name to look up side effects. Sorry, my family has two cases where the surgeon screwed up. We now look at the stats and efficacy !!!!!


Thanks for your responses everyone. Do you happen to know if Dr Robert in Nantes never uses steroid for any root nerve block or just not pudendal. I guess this is related to the second part of my question which is are all s2s3 blocks the same or can different nerves be blocked at s2s3 depending on where along the nerves the blocks are placed. I am waiting for an answer for this from Dr B, but thought I would ask here in the meantime.


I would recommend both. It is a very light sedation and is beyond helpful. Some are more painful than others, but it is nice not to leave a bigger pain memory than necessary, in the event of future treatments. It is my understanding, that all nerves below the space, yours being S2/S3 are affected. An example I received an L5-S1 for suspected back, but it relieved the pain in my pelvic nerves, as it serviced all nerve roots following through this space. It was a very good thing for me. I have had several without sedation and several with. I don't think I could handle it again without sedation. You are not "out" you are very aware of what is going on whilst sedated, it just takes the edge off.


Sorry I misunderstood your question. I had one with just anesthetic. It lasted until I got to the parking lot. But, it was a very good hour.


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