NERVE BLOCKS FOR PAIN
Often a group of nerves, called a plexus or ganglion, that causes pain to
a specific organ or body region can be blocked with the injection of
medication into a specific area of the body. The injection of this
nerve-numbing substance is called a nerve block.
HOW ARE NERVE BLOCKS USED?
Different kinds of nerve blocks are used for different purposes.
Therapeutic nerve blocks are used to treat painful
conditions. Such nerve blocks contain local anesthetic that can be used to
control acute pain.
Diagnostic nerve blocks are used to determine
sources of pain. These blocks typically contain an anesthetic with a known
duration of relief.
Prognostic nerve blocks predict the outcomes of
given treatments. For example, a nerve block may be performed to determine
if more permanent treatments (such as surgery) to block the activity of a
nerve would be successful in treating pain.
Preemptive nerve blocks are meant to prevent
subsequent pain from a procedure that can cause problems including phantom
Nerve blocks can be used, in some cases, to avoid surgery.
TYPES OF NERVE BLOCKS
Various areas of the body affected by pain require different nerve block types. Below are a
few of the available nerve blocks, followed in parentheses by
parts of the body for which they are often used.
- Trigeminal nerve blocks (face)
- Ophthalmic nerve block (eyelids and scalp)
- Supraorbital nerve block (forehead)
- Maxillary nerve block (upper jaw)
- Occipital nerve block (head)
- Cervical epidural, thoracic epidural, and lumbar
epidural block (neck and back)
- Cervical plexus block and cervical paravertebral
block (shoulder and upper neck)
- Brachial plexus block, elbow block, and wrist block
(shoulder/arm/hand, elbow, and wrist)
- Sciatic nerve block (back)
- Ilioinguinal nerve block (groin)
- Intercostal nerve block (ribs)
OTHER NERVE BLOCKS
Other types of nerve blocks include:
Sympathetic nerve block: A sympathetic nerve
block is one that is performed to determine if there is damage to the
sympathetic nerve chain, a network of nerves extending the length
of the spine. These nerves control some of the involuntary functions of
the body, such as the opening and narrowing of blood vessels.
Stellate ganglion block: This is a type of
sympathetic nerve block performed to determine if there is damage to the
sympathetic nerve chain supplying the head, neck, chest or arms and if it
is the source of pain in those areas. Although used mainly as a diagnostic
nerve block, the stellate ganglion block may provide pain relief in excess of
the duration of the anesthetic.
Facet joint block: Also known as a
zygapophysial joint block, the facet joint block is performed to determine
whether a facet joint is a source of pain. Facet joints are located on the
back of the spine, where one vertebra slightly overlaps another. These
joints guide and restrict the spine's movement.
SIDE EFFECTS OF NERVE BLOCKS
In some cases nerve blocks may cause:
- Elevated blood sugar level
- Elevated blood pressure
- Extra energy
- Soreness at the site of injection
Although many kinds of nerve blocks exist, this treatment cannot always
be used. If your pain is not localized in a single or small group of
nerves, nerve blocks may not be right for you. Your doctor will advise you
as to whether this treatment is appropriate.