The body includes groups of nerves that can cause pain to specific parts or organs. This type of nerve pain often occurs in the spine, but other common areas include the arms, legs, neck or buttocks. Injections of nerve-numbing medication into these areas are called nerve blocks, the purpose of which is to shut down (or “turn off”) a pain signal. This can provide pain relief and allow healing of a damaged nerve. In addition, these injections may also be used for diagnostic purposes. The patient’s response to the injection, which helps the doctor pinpoint the source or cause of the pain, can also facilitate guidance regarding further treatment. These nerve blocks, which take only minutes to administer, are indicated for treatment and management for those who suffer from both acute or chronic pain.
Genicular nerve blocks
Knee pain constitutes up to one-third of all doctor visits for bone or muscle pain issues. It is common for everyone from young athletes to those over 60. Genicular nerve blocks are effective for knee pain to the point of possibly avoiding knee replacement surgery. In addition, they can offer relief both before or following knee surgery. They are also indicated as providing relief for those who cannot undergo knee replacement. These injections address pain due to such common conditions as chronic knee pain, degenerative joint disease and osteoarthritis of the knee.
Hypogastric plexus blocks
These injections treat the hypogastric plexus, part of the sympathetic nervous system that impacts a number of body structures that can lead to visceral and pelvic pain. The most significant aspect of hypogastric plexus blocks is that they can treat pain from such a wide variety of origins, and all at once. For these nerve blocks, pain medication is administered through needles inserted in the back near each of the hip bones.
Lumbar sympathetic blocks
The sympathetic nerves, located on both sides of the spine in the lower back, belong to the autonomic nervous system. They control blood flow and temperature to the arms and legs. They also regulate heart rate, blood pressure, sweating and digestion. In addition to the relief of pain, injections hopefully alter the sympathetic nerves to a normal state of regulation. These nerve blocks are used to treat reflex sympathetic dystrophy (RSD) and complex regional pain syndrome (CRPS) (similar conditions resulting in aching or burning pain, swelling and cold or hot sensations in the limbs), shingles (involving the legs), vascular insufficiency and peripheral neuropathy.
Medial branch blocks
Medial branch blocks are directed to the medial nerves, which carry pain signals from the facet joints to the brain. Facet joints, located in the spine, provide back flexibility (so we can bend and twist), and they are the joints from which the nerves exit the spinal cord to other parts of the body. Depending on which facet joint is causing a problem, pain may occur anywhere from the lower back and into the buttocks. Occasionally, the pain will extend into the legs. Some of the conditions leading to inflammation and subsequent pain of the facet joints include osteoarthritis, spinal stenosis or trauma to the back, such as from an accident.
Selective nerve root blocks
Selective nerve root blocks address pain that may be felt anywhere in the upper or lower extremities, depending on the location of the affected nerve. In addition to pain, other symptoms may include numbness and tingling in the neck, shoulders or arms. Conditions which may cause this pain include cervical or lumbar radiculopathy, spinal stenosis, failed back surgery, bulging or herniated discs and arthritis.
Stellate ganglion blocks
The sympathetic nerves treated by stellate ganglion blocks supply feeling to the face and arm. If a nerve is impacted by trauma, infection or other causes, it can result in pain and other symptoms. Stellate ganglion blocks are commonly used for the treatment of complex regional pain syndrome (CRPS). They are also used for the treatment of pain and other symptoms from a wide variety of conditions. These include but are not limited to facial pain, shingles, causalgia (a condition following peripheral nerve injury), shoulder-hand syndrome, post herpetic neuralgia (PHN), phantom limb pain, Raynaud’s phenomenon, scleroderma, hyperhidrosis and hot flashes.