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 medication to reduce or block nerve transmissions to a specific organ or part of the area body. The result will often reduce pain and inflammation to the organ or area. Often, the spine is an area where the pain originates, where a corticosteroid nerve block needs to be applied to the space around the spinal column. The treatments are used to reduce pain and inflammation from complications of osteoarthritis, including spinal stenosis. Nerve blocks are effective for pain relief. Patients usually experience benefits a few days after the procedure.
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 spinal stenosis?
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 puts pressure on the nerve root that runs directly under the facet joint, “pinching” the nerves and causing pain, cramping, weakness or numbness.
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. The disease can’t be cured, but 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.
We may advise stopping herbal medications and supplements, fish oil and vitamin E three days before the procedure. The day before the procedure all anti-inflammatory medicines (Advil, Aleve) should be stopped.
You will 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 comprised in any day (any infections, cold/flu symptoms, high fever), the nerve block cannot be performed.
What can you expect during a nerve block?
The procedure is performed in a surgical facility using a live X-ray called a fluoroscope. 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) and moved into the facet joints. After the treatment site is cleaned, it will be covered with Band-Aids. You will be asked to wait in the recovery area for 30 minutes where your vital signs will be monitored.
What is the follow-up and recovery?
Regular exercise is very important. Physical therapy may also provide pain relief. 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 full day of rest, you may resume normal daily activities, including exercise, after the procedure.
What are the potential risks for a nerve block?
Possible side effects from a nerve block treatment include elevated blood sugar, itching, bleeding, and soreness at the site of injection. Nerve blocks may also result in extra energy in some individuals.