Nerve Blocks

Nerve blocks, or neural blockades, are procedures that can help prevent or manage many different types of intractable pain. They are often injections of medicines that block pain from specific nerves. They are meant to bring pain relief rather than total loss of feeling.

Perhaps the best-known nerve block is an epidural. Many pregnant women ask for an epidural during childbirth to ease the pain of labor and delivery. In an epidural, doctors inject an anesthetic drug into the space just outside the spinal column.

About nerve blocks

Nerve blocks require needles, often along with a fluoroscope or CT scan to properly guide the needle. The needles and guided images are used to inject pain-relieving or anti-inflammatory drugs into a nerve or group of nerves.

Illustration of the spine and nerve groups

This numbs the area and/or relieves inflammation. Sometimes chemicals or surgery is used to actually cut the nerve. Nerve blocks halt the pain messages coming from the nerves in a particular part of the body. They don't numb areas of the body that aren't in pain.

Types of nerve blocks

Nerve blocks can be temporary or permanent. Doctors can give them through regional or local anesthesia. They can also block pain signals to an area by deliberately cutting or destroying certain nerves during surgery.

These are types of surgical nerve blocks:

Sympathetic blockade. The doctor gives a drug to block pain from the sympathetic nervous system in one particular area.

Neurectomy. A damaged peripheral nerve is surgically destroyed.

Spinal dorsal rhizotomy. The surgeon cuts the root of the nerves that extend from the spine.

Benefits of nerve blocks

Nerve blocks can be used to manage other chronic, or long-term, pain, or severe acute, or short-term, pain. Nerve blocks ease pain by offering immediate relief. They can also offer longer-term relief, because some injections reduce irritation to the nerves and let them heal.

Nerve blocks can help people who have chronic pain function better in their daily lives, allowing them to go to work, exercise, and perform daily tasks.

Temporary nerve blocks are often a short-term fix. The pain may return within one to two weeks after the drugs wear off. Some people may need repeated or even long-term nerve block treatments to manage inflammation and pain.

Common uses for nerve blocks

Nerve blocks are often used during surgeries to ease pain. They may also be used to manage the pain of chronic health conditions or injuries in which the nerves are damaged, inflamed, or irritated.

Nerve blocks are commonly used to manage pain that comes from the spine, as well as debilitating pain that affects the arms, legs, neck, and buttocks.

Illustration of epidural insertion

You and your doctor may discuss a nerve block to manage these types of pain:

  • Labor and delivery pain

  • Cancer-related pain

  • Arthritis pain

  • Severe facial pain, such as trigeminal neuralgia

  • Low back pain

  • Headaches, including migraines and occipital neuralgia

  • Chronic regional pain syndrome, or CRPS

Other uses for nerve blocks

Doctors may use a nerve block as a tool to find out what is causing your pain and where it is coming from. By judging how you react to a temporary nerve block and how it affects your pain, your doctor can better figure out the reason for your pain, where it is located, and how to best treat it.

Risks of nerve blocks

Like all procedures, nerve blocks carry some risks. A nerve block can lead to bleeding and infection where the shot was given, the medication may spill into other areas unexpectedly, and doctors may hit the wrong nerve during surgery. Compared with many procedures, however, nerve blocks appear to be quite safe.