Nerve root HCLA injections are essential for neuropathic pain, as they provide diagnostic and therapeutic benefits. They can help identify the specific nerve root causing the pain and offer targeted pain relief by delivering a high concentration of local anaesthetic and corticosteroids to the affected nerve. These minimally invasive procedures minimise complications, allow outpatient treatment, offer a fast post-procedural recovery and reduce the need for surgery. The injections have therapeutic effects beyond the anaesthetic duration, reducing inflammation and interrupting pain signalling. By directly targeting the involved nerve root, they offer a tailored approach to manage neuropathic pain, increasing the chances of successful treatment. CASE STUDY: 43yo female right arm pain 1. Patient presents with neuropathic pain right arm to elbow 2. CT performed showing mild narrowing of C5/6 intervertebral foramen and possible compression of R C6 nerve root. 
Caused by uncovertebral osteophytes. 
3. Recommend C6 nerve root HCLA for treatment and diagnosis Diagnostic CT: Supine Irregular skin contour, long route to foramen (O = vertebral artery) 
4. Attends for nerve root injection
- Patient consented including risk of posterior circulation stroke
- Head turned to left
- Skin marker applied
- Radio-opaque lines
- Patient marked
- 1% lignocaine to skin using 25G needle
- Needle advanced to foramen
- Carefully avoid vertebral artery (O)
- Symptoms reproduced
- Mixture 4mg dexamethasone + 2mls 0.5% bupivacaine injected
- Pain resolved
Learning points:
- Mild foraminal narrowing cause radiculopathy
- HCLA injection was diagnostic as well as therapeutic
- Patient positioning is important in procedures
Qscan Group is proud to offer a range of interventional procedures and image-guided injections. With state-of-the-art technology our radiologists can capture high quality, detailed images allowing for a comprehensive view of the affected area and more accurate injection placement, for personalised treatment plans. If you think you may benefit from HCLA injections, speak to your doctor about your suitability for this procedure. HCLA injections are offered at select Qscan clinics.