What Are Nerve Blocks?

Nerve blocks are injections that are administered to provide a temporary reduction in pain symptoms. They may also be used to prevent pain. Some injections may provide longer relief than others. Nerve blocks can also help to determine the source of nerve pain. There are a few different types of nerve blocks, each dependent on the nerve it is targeting.

The effects of the injection usually happen quickly and provide temporary relief. However, some people may require more than one injection, and some people may not experience any relief from a nerve block.

Types of Nerve Blocks

There are several types of nerve blocks, each serving a specific purpose. Some nerve blocks are temporary, while others may be longer lasting. Some nerve blocks are used to prevent pain by blocking nerve signals to an area during surgery. Some of the different types of nerve blocks include:

• Sympathetic nerve block: Used to determine damage to the sympathetic nerve chain, which controls certain involuntary functions like blood vessel narrowing and opening.
• Neurectomy: Used when a peripheral nerve is surgically destroyed.
• Rhizotomy: Used when a surgeon destroys the root of nerves extending from the spine.
• Facet joint block: Also called a zygapophysial joint block, performed to determine if the facet joint is the source of pain.
• Epidural analgesia or anesthesia: Medication is injected outside the spinal cord, commonly used during labor and delivery.
• Spinal anesthesia or analgesia: Medicine is injected into the fluid surrounding the spinal cord.
• Peripheral nerve block: Medication is injected around a targeted nerve causing pain.
• Celiac plexus nerve block: Relieves pain caused by pancreatic cancer or chronic pancreatitis.
• Genicular nerve block: Reduces chronic knee pain or postoperative knee pain.
• Intercostal nerve block: Provides temporary pain relief from rib fractures and treats nerve pain (neuralgia).
• Occipital nerve block: Helps diagnose and treat occipital headaches and chronic migraines.
• Pudendal nerve block: Blocks pain in the pelvic region, labor, delivery, or genital pain.
• Stellate ganglion block: Relieves head, neck, upper arm, and chest pain and improves blood flow.
• Trigeminal nerve block: Treats different causes of facial pain.

Nerve Block Use Cases

Nerve blocks have many common uses. General uses include:

• Pain after surgery
• Labor and delivery pain
• Arthritis pain
• Cancer-related pain
• Lower back pain
• Severe facial pain (trigeminal neuralgia)
• Severe headaches (migraines or occipital neuralgia)
• Chronic regional pain syndrome (CRPS)

How Nerve Blocks are Performed

A nerve block is typically performed as an outpatient procedure, and you can go home shortly after the procedure is finished. The procedure involves a doctor inserting needles with the pain-relieving or anti-inflammatory drug around the nerve or group of nerves. A doctor is usually guided by the use of a fluoroscope, ultrasound, or CT device. The imaging devices help the doctor see better where the needles with the nerve blocking agent will be administered. In some cases, a doctor may use low electrical stimulation to locate the specific nerve causing pain.

Once the injections are administered, the area should become numb or there should be a reduction in inflammation. Nerve blocks work by stopping the pain messages coming from the nerves from getting to the brain. If the messages never reach the brain, the brain cannot decode the messages into an experience or feeling of pain.

How Long Does a Nerve Block Usually Last?

Some nerve blocks last for a short or temporary amount of time, while other nerve blocks may last much longer. Nerve blocks can last anywhere within the range of 4-24 hours, depending on the type used. The length of time a nerve block lasts varies between individuals. Some people experience a complete reduction of pain after a single injection, while other people may need multiple treatments. Other people may experience no relief at all.

Risks and Benefits

There are several benefits and potential risks associated with nerve blocks. Benefits include:

• Temporary or permanent reduction in pain
• Temporary or permanent reduction in inflammation of the affected nerve, increasing the chances of the nerve to heal
• May help your provider diagnose the cause of the pain

Although risks of a nerve block are rare, potential risks may include:

• Bleeding at the injection site
• Infection at the injection site
• The medication could inadvertently get into your bloodstream
• The medication could unexpectedly spread to other nerves or your spinal canal, depending on the type of block being administered
• Difficulty in swallowing (only with a stellate ganglion block)
• Gastroparesis or delayed emptying of the stomach contents (only with a celiac plexus block)

What Are the Side Effects of a Nerve Block Injection?

Common side effects of nerve block injections include:

• Rash
• Itching
• Blood sugar elevation
• Excess energy
• Weight gain
• Soreness at the injection site
• Bleeding

Preparing for a Nerve Block

Typically, there is no preparation needed for a nerve block. In certain cases, your healthcare provider may recommend sedation for the procedure. If sedation is needed, you will be required to fast 6-8 hours beforehand. You will also need someone to drive you home.

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