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.  Nerve blocks are used for pain treatment and management. There are several different types of nerve blocks that serve different purposes. 

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 limb pain.
  • Nerve blocks can be used, in some cases, to avoid surgery.
 
Types of Nerve Blocks
  • 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)
  • Subarachnoid block and celiac plexus block (abdomen and pelvis)
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. This is a network of nerves extending the length of the spine. These nerves control some of the involuntary functions of the body, such as opening and narrowing 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 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 spines movement.
 
Nerve Blocks
Although many kinds of nerve blocks exist, this treatment cannot always be used. If your pain isn't related to pain in a single or small group of nerves, nerve blocks may not be right for you. Your doctor can advise you as to whether this treatment is appropriate for you.
 
Key Benefits of Needling, Infiltration, and Trigger Point Injections
  • Trigger point injection stops the pain and relieves muscle spasms immediately, allowing active movement (limbering exercises). Trigger point injection accelerates substantially the recovery in both muscle and ligament sprain 
  • "Needling" in order to break up mechanically the painful and tender tissue is combined with infiltration by local anesthetic, (trigger point) injections 
  • Preinjection blocks (PIB) prevent pain from needle penetration
Trigger point injection (TPI) is used to treat extremely painful areas of muscle. Normal muscle contracts and relaxes when it is active.A trigger point is a knot or tight, ropy band of muscle that forms when muscle fails to relax. The knot often can be felt under the skin and may twitch involuntarily when touched (called a jump sign).
The trigger point can trap or irritate surrounding nerves and cause referred pain — pain felt in another part of the body. Scar tissue, loss of range of motion, and weakness may develop over time.
Medical specialists such as a physiatrist, pain specialist, or neurologist can administer TPI. Injections are given in the physician's office and takes approximately 30 minutes. Before performing TPI, the physician may give the patient a nerve block to prevent pain from needle penetration.
A small needle is inserted into the trigger point and a local anesthetic (e.g., lidocaine, procaine) with or without a corticosteroid is injected. Injection of medication inactivates the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes.
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