Nerve Blocks
What is a Nerve Block?
A nerve block is an anesthetic or anti-inflammatory injection targeted toward a certain nerve or group of nerves to treat pain. The purpose of the injection is to “turn off” a pain signal coming from a specific location in the body or to decrease inflammation in that area.
Imaging guidance, such as fluoroscopy or ultrasound imaging, may be used to help the doctor place the needle in exactly the right location so that the patient can receive maximum benefit from the injection.
What are some common uses of the procedure?
People who suffer from either acute or chronic pain might have a nerve block injection to achieve temporary pain relief. Often, such pain originates from the spine, but other areas commonly affected include the neck, buttocks, legs and arms. Delivering a nerve block injection allows a damaged nerve time to heal itself from a state of constant irritation. Additionally, nerve blocks can provide diagnostic information to the doctor. By performing a nerve block and then monitoring how the patient responds to the injection, the doctor can often use this information to help determine the cause or source of the pain.
How should I prepare for the procedure?
Usually, no special preparation is required prior to arrival for a nerve block procedure.
You may be asked to wear a gown during the procedure.
You will probably be asked to use the restroom before the procedure.
You will then be positioned on your stomach or side on a special fluoroscopic or ultrasound table that will give the doctor easy access to the injection site(s). The nurse will help to make you as comfortable as possible, both during and after the procedure.
What does the equipment look like?
The injection itself will be administered with a syringe much like one that would be used for a routine vaccination. The doctor will fill the syringe from a small vial of medication. The type of medication used depends on individual patient needs.
The imaging guidance used, such as fluoroscopy or ultrasound imaging, will require additional equipment around the table. Both types of imaging are painless and involve the use of x-rays to obtain essential images that allow the physician to place the needle in exactly the right location for the injection.
The equipment typically used for this examination consists of a radiographic table, one or two x-ray tubes and a television-like monitor that is located in the examining room. Fluoroscopy, which converts x-rays into video images, is used to watch and guide progress of the procedure. The video is produced by the x-ray machine and a detector that is suspended over a table on which the patient lies.
The ultrasound imaging may also be used and provides and imaging by use of a probe and coupling gel on the skin to project real time imaging on the ultrasound machines monitor. This is used to guide the needle into place.
How does the procedure work?
The medication delivered by the injection will be placed as close to the nerve causing the pain as possible. It will then “shut down” the pain receptors within the nerve(s) causing the problem. Imaging can help the doctor place the needle in exactly the right spot. The imaging itself is painless.
The effects of the injection are usually immediate. It only takes a short time for the medication to achieve pain relief. However, nerve blocks are only a temporary fix—they typically last for up to one or two weeks and then wear off as they are absorbed by your body. Some patients undergo several rounds of nerve blocks before they feel a more permanent sense of relief. Others may not receive any permanent pain relief from this type of injection and may require different treatment methods to manage the pain or inflammation.
How is the procedure performed?
This procedure is often done on an outpatient basis. However, some patients may require admission following the procedure. Please consult with your physician as to whether or not you will be admitted.
Nerve blocks usually take only minutes to administer.
You will be positioned on a table or other surface to allow the doctor access to the site(s) to be injected. The doctor will then identify the spot the needle needs to be placed, using palpation and/or imaging guidance. He or she will clean the area with antiseptic solution, and then the needle will be inserted at a specific depth to deliver the medication as close to the problematic nerve(s) as possible.
More than one injection may be required, depending on how many areas of pain you have or how large an area needs to be covered. The doctor will most likely tell you when he or she inserts the needle and when the injection is done.
When finished, you will be allowed to rest for 15 to 30 minutes to let the medication take effect. The assistant will also make sure you don’t have any unexpected side effects before you leave the doctor’s office.
What will I experience during the procedure?
You will probably feel a “pinch” when the needle is inserted. As soon as the medication is delivered, though, you should feel less discomfort. Sometimes the needle has to be inserted fairly deep to reach the nerve causing your problem. This can be temporarily uncomfortable, but it is important to hold still so that the needle is inserted correctly.
If you require an injection close to a major nerve or bundle of nerves, such as the sciatic nerve, your doctor will tell you to speak up if you get a sudden jolt of pain. This means that the needle has come too close to the major nerve and will need to be retracted and re-positioned. This happens rarely, however, so it should not be a major concern.
After the injection, you will probably experience a sensation of pain relief in the area injected. This will typically last several months, or even permanently in some cases.
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