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Pain management and nerve blocks

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

Often a group of nerves - called a plexus or ganglion - that causes pain to a particular organ or body region can be blocked through the injection of medication into a specific area of the body. Injecting this nerve-numbing substance is known as 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. They contain local anaesthetic that can be used to control acute pain.
  • Diagnostic nerve blocks are used to determine sources of pain. These blocks typically contain an anaesthetic with a known duration of relief.
  • Prognostic nerve blocks predict the outcomes of treatments. For example, a nerve block may be performed to determine whether more permanent treatments (such as surgery) to block the activity of a nerve would be successful in treating pain.
  • Pre-emptive nerve blocks are designed to prevent subsequent pain from a procedure that can cause problems, such as phantom limb pain.

Nerve blocks can also be used, in some cases, to avoid surgery

Types of nerve blocks

Various areas of pain require different types of nerve blocks. Listed below are a few of the available nerve blocks, followed in brackets by some of the body parts they are used for.

  • Trigeminal nerve block (face)
  • Ophthalmic nerve block (eyelids and scalp)
  • Supraorbital nerve block (forehead)
  • Maxillary nerve block (upper jaw)
  • Sphenopalatine nerve block (nose and palate)
  • 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 used to determine whether there is damage to the sympathetic nerve chain. This is a network of nerves extending along the length of the spine. The 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 whether there is damage to the sympathetic nerve chain supplying the head, neck, chest or arms, and whether it is the source of pain in those areas. Although used mainly as a diagnostic block, the stellate ganglion block may provide pain relief beyond the duration of the anaesthetic.
  • Facet joint block. Also known as a zygapophysial joint block, the facet joint block is used 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 and risks of nerve blocks

Nerve blocks do have risks and side-effects. They include:

  • Elevated blood sugar
  • Rash
  • Itching
  • Weight gain
  • Extra energy
  • Soreness at the site of injection
  • Bleeding
  • Death (in rare cases)

Although many kinds of nerve blocks exist, this form of treatment cannot always be used. If your pain isn't related to a single nerve or small group of nerves, nerve blocks may not be right for you. Your doctor can advise you on whether this type of treatment is appropriate for you.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on August 09, 2012

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