A nerve block (also called a neural blockade) can help prevent or manage pain. The procedure involves the application of medicine to a nerve to block pain signals from reaching the brain from that nerve. A common nerve block is an epidural to help ease the pain of labor and delivery for pregnant women.
Nerve blocks can be temporary or long-lasting. They are especially helpful in managing chronic, acute, and short-term pain. A nerve block can also help reduce nerve irritation to allow healing.
Nerve blocks can help manage chronic pain originating in the spine, arms, legs, neck, and buttocks. A nerve block is also helpful in discovering the exact source of pain. In addition to relieving pain, nerve blocks can stop the sensation of feeling during surgery.
Celiac Plexus Block
A celiac plexus block is a minimally invasive pain management procedure that can help relieve abdominal pain commonly caused by cancer or chronic pancreatitis. The treatment involves an injection of numbing medicine directly into the celiac plexus nerve bundle, which surrounds the aorta under the diaphragm. Cancerous tumors pressing on these nerves can cause pain.
Continuous Catheter Nerve Block
A continuous catheter nerve block (also called a continuous peripheral nerve block) can help manage chronic pain by providing pain relief medicine to a specific area of the body. The nerve block is a safer alternative to opioids and typically has fewer side effects, often caused by high doses of oral pain medications.
The nerve block delivers a continuous supply of pain medication by a catheter, a threadlike soft plastic tube placed under the skin near the nerve responsible for the pain. Once in place, the catheter can provide long-term pain management; the most common is to help control post-operative pain. However, catheter nerve blocks effectively treat all types of pain, especially chronic pain that is unresponsive to more conservative treatments, such as cancer-induced pain, complex regional pain syndrome, or phantom limb pain.
Woman in hospital child birthing room
Ganglion Impar Block
A ganglion impar block is an injection into a nerve bundle just in front of the lowest part of the spine (sacrum) and just above the tailbone (coccyx). The nerves typically control blood flow and can be the source of long-lasting (chronic) pain. The block can be an effective treatment option for chronic pelvic, groin, and rectal pain. It can also be effective in treating pain in the tailbone (coccydynia), a condition more common in women than men.
A ganglion impart block can also be effective in helping diagnose the cause of the pain.
Illustration of the placement of the ultrasound probe and needle over the sacrococcygeal joint between the sacrum and the base of the coccyx (tailbone)
Fluoroscopic view of injections of contrast (black arrows) during lumbar sympathetic ganglion block
Intercostal Nerve Block
An intercostal nerve block can help relieve intercostal neuralgia, a nerve pain that affects the ribs, chest, or upper abdominal area. The nerves are a part of the peripheral nervous system and are associated with voluntary movements of the skeletal muscles.
An intercostal nerve block consists of a steroid injection in the chest targeting the intercostal nerves. The injection consists of a steroid medication and a local anesthetic to help reduce the inflammation and pain resulting from surgery or a herpes zoster infection (shingles).
In some cases, an intercostal nerve block can help diagnose the source of pain in the chest wall.
Doctor injecting medication into the space (area between the ribs) of a patient
With the palpating hand holding the needle firmly and resting securely on the patient’s back, the injecting hand gently “walks” the needle while the skin is allowed to move back over the rib
An interscalene block is the injection of a local anesthetic around the brachial plexus near the scalene muscles on each side of the neck. The scalene muscles allow the neck to bend and rotate and assist in breathing.
The procedure provides pain management for shoulder and upper arm surgery patients. Surgeons often perform shoulder surgery using an interscalene block in conjunction with general anesthesia. The block can help patients begin physical therapy and other treatments to speed healing.
Medial Branch Block
A medial branch block is a minimally invasive, non-surgical injection to treat neck and back pain. The block is similar to a facet injection; however, the medial branch block injects medicine outside the joint space. A facet injection places the medication directly into the facet joint. Both treatments, however, can help block pain signals from reaching the brain.
The block consists of injecting an anesthetic near small medial nerves connected to a specific facet joint where the pain originates. Typically, several facet joints receive an injection during the procedure.
A medial branch block is primarily a diagnostic procedure. If there is a marked improvement in pain immediately after the injection, the procedure confirms the facet joint where the pain originates. The block can help diagnose and relieve sacroiliac joint pain and osteoarthritis of the back.
The needle is targeted just lateral to the facet joint; SP – spinous process; FJ – facet joint; TP – transverse process
Obturator Nerve Block
An obturator nerve block is an injection of medicine directly into the nerve to stop pain signals from reaching the brain. The obturator nerve provides both motor function to muscles in the leg and sensory functions to a portion of the thigh skin.
The injection can consist of a local anesthetic to numb pain or a steroid to help reduce inflammation. A fluoroscope (x-ray) or ultrasound helps with precise needle placement.
Blocking the obturator nerves can help treat hip pain associated with cerebral palsy and muscle spasms associated with paralysis of the legs.
Occipital Nerve Block
An occipital nerve block is an injection of a combination of pain medicine and steroids in the back of the head to help reduce inflammation of the occipital nerve. The occipital nerve, located between the first and second cervical vertebrae, supplies sensation to the skin along the back of the scalp to the top of the head. The nerve may also contribute to headaches.
Multiple injections may be necessary to help keep the pain under control.
Area the transducer image (purple line) is viewing of neck
Sphenopalatine Ganglion Block
A sphenopalatine ganglion block is the injection of a numbing medicine into a bundle of nerves deep within the face. Typically, the patient is under sedation while the doctor uses X-ray (fluoroscopy) guidance to inject an anesthetic into the sphenopalatine ganglion nerves.
The nerve bundle is closely associated with the trigeminal nerve, which lies within the skull’s bony cavities on either side of the nose. A sphenopalatine ganglion block can help treat acute or chronic migraine, cluster headaches, and many types of facial pain. It can both diagnose and treat pain.
Stellate Ganglion Block
A stellate ganglion nerve block is an injection of medicine that numbs branches of nerves in the neck that are a part of the sympathetic nervous system. The nerves are associated with a wide range of bodily functions, such as heart rate, sweating, and pupil dilation.
The injection bathes the nerves to help reduce inflammation and relieve the pain. Treatment may require a series of injections.
The procedure can help diagnose and treat head, neck, arms, and chest pain.
Superior Hypogastric Plexus Block
A superior hypogastric plexus block (sometimes called a hypogastric block) is an advanced, minimally invasive procedure for treating pelvic and genital pain. The block is an injection of a pain-killing medication into this network of nerves. It is a pain treatment option when other procedures have failed to provide relief.
The superior hypogastric plexus is a branching network of nerves found near the base of the spine, a part of the sympathetic nervous system, responsible for transmitting subconscious sensations to and from the pelvic region.
The superior hypogastric plexus block is a pain treatment option if oral medications and other conventional treatments fail to provide pain relief.
A sympathetic block (also called a sympathetic nerve block) is an injection of medications (for example, steroids) around the sympathetic nerve roots located along the spine to help ease and control chronic pain. Sympathetic nerves are a part of the autonomic nervous system, which controls bodily functions you do not have to think about or have direct control over, like temperature, heart rate, and digestion.
During a sympathetic block, a steroid medication and a local anesthetic are injected into the area around the sympathetic nerves to help temporarily reduce or eliminate pain.
A sympathetic block may provide weeks or months of pain relief. In some patients, the amount of pain relief may decrease over time. Additional injections may be repeated as needed if the pain continues to improve after each injection.