Nerve Blocks

What Are Nerve Blocks?

Nerve blocks are injections of medication around specific nerves to interrupt pain signals. They can be used for diagnosis (to identify pain sources), treatment (to provide temporary or longer-lasting relief), or both. Nerve blocks are performed by pain specialists, anesthesiologists, or interventional radiologists.¹

How They Work²

• Medication injected near target nerve(s)
• Blocks transmission of pain signals
• Local anesthetic provides immediate relief
• Steroid may provide longer-term relief
• Some blocks destroy nerve tissue (neurolytic)

Types of Nerve Blocks

Diagnostic Blocks

• Use local anesthetic only
• Help identify pain source
• Short-acting relief indicates target nerve

Therapeutic Blocks

• Often include steroid
• Aim for longer-lasting relief
• May need repeating

Neurolytic Blocks

• Destroy nerve tissue
• Longer-lasting but riskier
• Used for cancer pain or specific conditions

Common Nerve Block Locations

• Facet joint blocks (spine)
• Epidural steroid injections
• Sympathetic nerve blocks
• Occipital nerve blocks (headaches)
• Intercostal blocks (rib pain)
• Peripheral nerve blocks
• Trigger point injections

Conditions Treated³

• Back and neck pain
• Sciatica
• Headaches and migraines
• CRPS (complex regional pain syndrome)
• Arthritis pain
• Nerve entrapment syndromes
• Cancer pain
• Shingles/postherpetic neuralgia

What to Expect

Before

• May need to stop blood thinners
• Usually outpatient procedure
• May need driver home

During

• Skin numbed with local anesthetic
• Imaging guidance often used (X-ray, ultrasound)
• Procedure takes 15-30 minutes
• Mild discomfort during injection

After

• Observation period
• Temporary numbness possible
• Rest day of procedure
• Relief may be immediate or delayed

Risks and Side Effects

• Injection site soreness
• Temporary numbness or weakness
• Infection (rare)
• Bleeding (rare)
• Nerve damage (rare)
• Allergic reaction (rare)

References

1. Manchikanti L, Kaye AD, Manchikanti K, et al. Efficacy of epidural injections in the treatment of lumbar central spinal stenosis. Anesth Pain Med. 2015;5(1):e23139.
2. Cohen SP, Bicket MC, Jamison D, et al. Epidural steroids: a comprehensive, evidence-based review. Reg Anesth Pain Med. 2013;38(3):175-200.
3. Manchikanti L, Singh V, Cash KA, et al. Management of facet joint pain: a practical approach. Curr Rheumatol Rev. 2008;4(4):266-279.