Board Certified, New York City Based, Osteopath Specializing in Spine, Pain and Sports Medicine
What is a nerve block?
A nerve block is an injection of anesthetic medication to reduce or block nerve transmissions to a specific part of the area body (region of nerve innervation). The result will often reduce or eliminate pain to the region. When the spine is an area where the pain originates, a nerve block may be applied to the specific nerves such as the medial branches that innervate the facet joints. The treatments may be used for both diagnostic and therapeutic purposes and can be utilized to reduce pain and inflammation from complications of osteoarthritis and spinal pain. Nerve blocks are effective for pain relief. Patients usually experience benefits for the duration of the block.
Why is a nerve block performed?
Nerve blocks are used for pain treatment and management. The injection will “block,” or numb, nerves in a specific area of the body. Nerve blocks can be therapeutic and useful for relieving pain or can be for diagnostic purposes to confirm a diagnosis.
Nerve blocks are performed when the source of pain is caused by the nerves and could be applied to numerous areas of the body.
What is facet arthropathy?
Facets are small joints between and behind each vertebral level of the spinal column that allows for stability and movement. Facet joint capsules surround the facet joints and the fluid protects and lubricates the joints. As they are always in motion, helping us to rotate and bend our backs, they can wear down or tear easily.
When this happens, the cartilage protecting the joint thins and ultimately disappears resulting in bone overgrowth and enlarged joints. The enlarged joint can become painful and put pressure on the nerve root that runs directly under the facet joint, “pinching” the nerves and causing pain, cramping, weakness or numbness. The facet may also become inflamed due to incorrect biomechanical loading patterns either traumatically (motor vehicle accident) or chronically through incorrect lifting or sitting posture.
What is spinal stenosis?
This narrowing of space in the spinal column is called stenosis and commonly occurs in lower back and neck. It is typically caused by osteoarthritis. There are a variety of treatment options to reduce pain and improve flexibility and mobility. The best treatment for you depends on the severity of your symptoms.
How do you prepare for a nerve block?
We will review a list of your current medications before the procedure. We may ask that you stop taking medications one week before in preparation for the procedure. In certain circumstances, we will seek medical clearance from your primary provider for certain medications.
Depending on the reason and type of block performed, you may not be able to drive immediately after the procedure, so arranging for someone to drive you home after the procedure is important. It is advisable not to drive or experience any strenuous activity such as heavy lifting or operating machinery for at least 1 day after the procedure. If your immune system is compromised (any infections, cold/flu symptoms, high fever), the nerve block will be rescheduled.
What can you expect during a nerve block?
The procedure may be performed in a surgical facility using a live X-ray called a fluoroscope, or in the office utilizing ultrasound guidance. You will be asked to lay on your stomach or on your side during the procedure. Anesthesia will be provided to calm any tension before the procedure. Any burning or tingling from the anesthetic will lessen in seconds.
Treatment will be guided by an X-ray (fluoroscope) or ultrasound. After the treatment site is cleaned and will be covered with Band-Aids.
What is the follow-up and recovery?
Physical therapy may also provide additional benefit and optimize outcomes. At Network Spine, we offer on-site physical therapy. Any pain around the treatment site can be treated with ice. You may also feel warm sensation around the site for a few hours after the procedure, but this will subside on its own. After one day of rest, you may gradually resume normal daily activities, including exercise, after the procedure.
What are the potential risks for a nerve block?
Most side effects are minor and self-limiting. Possible side effects from a nerve block treatment can include soreness at the injection site, bleeding, bruising. If corticosteroids are used diabetics may experience elevated blood sugar, a feeling of extra energy, and rarely a steroid “flush”. A steroid flush is a transient feeling of warmth and possible elevated temperature that may last for a few days following treatment.