A nerve block is an interventional pain management procedure used in the diagnosis or treatment of chronic pain. Also referred to as neural blockades, nerve block procedures have been used for over a century, originally for the treatment of lower back pain. Today’s nerve block procedures are far more sophisticated and safe, performed in a sterile operating room on an outpatient basis by a pain management physician, usually an anesthesiologist. Nerve block procedures are similar to getting a Novacaine shot at the dentist, and usually take only minutes to administer.
During a nerve block procedure the doctor uses an anesthetic injection targeted toward a specific nerve or group of nerves believed to be the source of the chronic pain. The anesthesia works to interrupt the pain signals coming from the overactive nerve or group of nerves, preventing the brain from receiving and processing them. The injection may also contain anti-inflammatory such as a corticosteroid to reduce inflammation and help damaged tissue and muscle to heal. Numerous studies have shown that nerve block procedures are extremely effective in providing temporary to long term relief of chronic pain, as well as increasing range of motion to the affected area.
What to Expect During a Nerve Block Procedure
Prior to the procedure the patient will be placed on a table in a sterile operating room and encouraged to relax. The physician will use imaging guidance (x-rays, MRI, CT scans or fluoroscopy) and neuropsychological studies (EMG and Nerve Conduction) to permit accurate diagnosis of the chronic pain and allow for accurate placement of the needle so the patient receives the maximum benefit from the injection.
Before the needle is inserted, the doctor will clean the area with an antiseptic solution. He or she will let you know when the needle is being inserted, when the injection is taking place, and when the procedure is over. Depending on how many areas of pain you have or how large the pain area is, more than one injection may be required. Afterwards you’ll be instructed to rest for 15 to 30 minutes while the medication takes effect, and to make certain there aren’t any unanticipated side-effects. Once the doctor has determined everything is ok, you’ll be allowed to leave.
Nerve Block as a Diagnostic Tool
Nerve Block procedures can also be used to diagnose chronic pain when the source of the chronic pain is unknown. In this procedure, the physician injects a small amount of anesthetic onto a set of target nerves, then waits to assess whether there is any change in pain symptoms. If a particular pain-carrying nerve or group of nerves is/are numbed and a patient notes significant improvement in pain symptoms, the location of the chronic pain source is confirmed. Conversely, if a patient has no change or only limited change in pain symptoms following an injection, it is likely the chronic pain is originating from a different area and more test injections will be necessary.
Nerve Block Pros and Cons
Nerve blocks have proven extremely effective at treating chronic pain due to damaged or deteriorated discs and joints, as well as occipital neuralgia, neuropathic and sciatic nerve pain. They are also effective in relieving pain in the arms, legs, neck and back, whether the pain is from nerve damage, burns or damaged tissue and muscle.
Although considered extremely safe in the medical community, nerve blocks do come with associated side-effects that every patient should be aware of prior to undergoing the procedure. These include elevated blood sugars, weight gain, increased energy, bleeding, and soreness or itching at the injection site. Your doctor will perform a complete physical exam to determine if you’re a good candidate for the procedure, so the chances of any negative side effects are very small.
To the person experiencing chronic pain, nerve blocks can provide welcome relief, reducing pain for as little as a few hours or for as long as several weeks. In cases where pain is from damaged tissue and muscle, nerve blocks can also act as an anti-inflammatory and give your body a chance to heal so the chronic pain is eliminated permanently.