What is a nerve block? Are there more than one?

Nerve blocks are essentially what the name implies: They block is to disrupt pain signals along a nerve(s) before they can be processed by the brain. Nerves transmit sensations like pain from the site in question to the brain. Blocks involve injecting various types of medications around the nerve or nerves to stop the transmission of pain.

There are two main types of nerve blocks that may be performed at different points in the body; some nerve blocks will be diagnostic, helping doctors find the source of the pain to better determine future treatment, while other blocks may be therapeutic, providing prolonged pain relief.

• Diagnostic blocks are utilized to determine if a specific nerve or nerves are the source of the problem. For this procedure, a temporary numbing agent is injectied around the nerve or nerves in question to relieve pain for a few hours or up to a few days. You will then be told to go about your day, moving around as normal and monitoring your pain levels for signs of improvement. If both you and your physician deem the block successful, you may have another block to verify these results, rule out any potential placebo, or just move on to a treatment with more longevity in mind like a radiofrequency ablation or rhizotomy. 
• Therapeutic blocks aim to relieve pain for a longer period of time. This is due to the type of medication injected around the nerves, which will include an anesthetic for short-term relief and an anti-inflammatory medication for longer relief like a corticosteroid.

Nerve block overview

You will remain awake during the procedure, however there are times where IV medications may be provided to make the procedure more comfortable. Your physician will use a local anesthetic to numb the area around the nerves as well before proceding. A state-of-the-art X-ray device called a fluoroscope will be used to help guide the needle into place. This is necessary as to keep the physician accurate and keep the patient safe. Once identified, a mixture of pain-relieving medications will then be injected around the painful nerves.

Following the procedure, you will usually be able to go home in about 30 minutes. After a nerve block, people may feel soreness at the site of the injection.

Outcomes of Treatment. 

The ultimate goal of therapeutic nerve blocks is to decrease pain. With this concordant decrease in pain, we also hope to add to this goal things like, increased functional status, decreased opioid usage, and increased ability to perform physical therapy and other maintenance or preventative modalities. All individuals respond differently to procedures and this does include nerve blocks. 

After the nerve block procedure, it’s possible that the pain may return after the anesthetic wears off but before the anti-inflammatory medication takes effect. This is normal and should decrease within a few days. Give yourself one full week to experience the full benefits. Sometimes, more than one injection will be required to provide sustained relief from pain. With each repeat injection, a more robust anti-inflammatory response will provided and helps to not only eliminate any residual pain, but to keep symptoms from returning as well.