Diagnostic & Therapeutic Nerve Blocks in Midtown Manhattan
Targeted nerve block evaluation for selected rib, knee, shoulder, hand, wrist, foot, ankle, hip, thigh, low back, and peripheral nerve pain patterns.
Network Spine provides selective image-guided nerve blocks for patients whose symptoms suggest irritation of a specific sensory nerve or peripheral nerve pathway. Care is designed for patients seeking diagnostic clarity, practical treatment options, and a measured approach before considering more invasive care.
Nerve blocks are not used automatically for pain. They are considered when the clinical history, physical examination, imaging when relevant, and prior treatment response suggest that a specific nerve may be contributing to symptoms.
Who This Page Is For
This page is for patients with persistent or recurrent pain patterns that may involve a peripheral nerve, including pain that is localized, radiating, burning, sharp, sensitive to touch, or difficult to explain through joint or spine imaging alone.
Common reasons for evaluation include:
Knee pain with possible sensory nerve contribution
Shoulder pain with suspected suprascapular nerve involvement
Hand, wrist, forearm, foot, or ankle nerve pain patterns
Anterolateral thigh pain or numbness
Low back, iliac crest, or hip pain that may involve cluneal nerves
Pain that has not responded adequately to prior conservative care
This page is not intended for emergency symptoms, acute chest pain, progressive neurologic weakness, or symptoms requiring urgent medical evaluation.
What Is a Nerve Block?
A nerve block is an injection placed near a specific nerve or nerve pathway. Depending on the clinical goal, the injection may be used diagnostically, therapeutically, or both.
A diagnostic nerve block can help determine whether a specific nerve is contributing to pain. A therapeutic nerve block may be considered when the goal is to reduce irritation around a nerve and support improved function, activity tolerance, or rehabilitation.
Response to a nerve block varies. A meaningful response may help clarify the pain generator, but it does not guarantee that future treatment will be successful or that pain will resolve completely.
When a Nerve Block May Be Appropriate
A nerve block may be considered when symptoms and examination findings suggest that pain may be coming from a specific nerve rather than only from a joint, disc, muscle, tendon, or ligament.
Appropriate cases may include:
Localized nerve-type pain in a recognizable distribution
Pain that is reproduced by palpation or mechanical irritation near a nerve pathway
Persistent symptoms despite activity modification, rehabilitation-based care, medication trials, osteopathic manipulative treatment, or other appropriate conservative measures
Pain patterns where diagnostic clarification may change the treatment plan
Cases where imaging findings do not fully explain the patient’s symptoms
Nerve blocks are used selectively. Not every nerve-related pain pattern requires an injection, and not every abnormal imaging finding requires procedural care.
Use Alongside Other Treatment
In selected cases, a nerve block may be used alongside osteopathic manipulative treatment (OMT), physical therapy or rehabilitation, or another procedure as part of a broader treatment plan.
Temporarily reducing irritation in a specific nerve pathway may improve procedural comfort or make it easier to address related muscular guarding, restricted motion, or movement patterns. In some patients, this may help create a more practical opportunity to participate in rehabilitation or tolerate hands-on treatment directed at other contributing factors.
Nerve blocks may also be used with selected rib, joint, ligament, tendon, or soft-tissue procedures when a nearby nerve contributes to sensitivity in the treatment region.
Nerve blocks are not added automatically. The decision depends on the suspected pain generator, anatomy, examination findings, planned treatment, safety considerations, and whether the additional injection is expected to provide meaningful diagnostic or therapeutic value.
Different components of care may address different contributors to the same clinical problem.
Types of Nerve Blocks
Nerve blocks are selected based on symptom location, examination findings, prior treatment response, anatomy, and the suspected pain generator. Depending on the clinical pattern, evaluation may include consideration of:
Intercostal nerve blocks for selected rib pain, chest wall pain, or intercostal nerve irritation
Genicular nerve blocks for selected knee pain patterns, particularly when pain appears to involve sensory nerves around the knee
Suprascapular nerve blocks for selected shoulder pain patterns
Median, ulnar, or radial nerve blocks for selected hand, wrist, or forearm nerve pain patterns
Tibial, sural, superficial peroneal, deep peroneal, or related peripheral nerve blocks for selected foot and ankle nerve pain patterns
Tarsal tunnel–related nerve blocks when symptoms suggest irritation around the tibial nerve or its branches
Lateral femoral cutaneous nerve blocks for selected anterolateral thigh pain, numbness, or meralgia paresthetica–type patterns
Superior cluneal nerve blocks for selected low back, iliac crest, or upper buttock pain patterns
Stellate ganglion blocks in carefully selected cases when the indication is appropriate and the risk-benefit profile is reasonable
Occipital, supraorbital, supratrochlear, and sphenopalatine ganglion blocks for selected headache, scalp, forehead, facial pain, or craniofacial pain patterns when the history and examination suggest involvement of peripheral sensory nerves or autonomic pain pathways
The goal is not to “block every nerve.” The goal is to determine whether a specific nerve is clinically relevant and whether a diagnostic or therapeutic injection is reasonable.
Headache and Facial Pain–Related Nerve Blocks
In selected cases, nerve blocks may be considered for headache, scalp, forehead, facial pain, or craniofacial pain patterns when the clinical history and examination suggest involvement of peripheral sensory nerves or related pain pathways.
Depending on the pattern, this may include occipital nerve blocks, supraorbital nerve blocks, supratrochlear nerve blocks, or sphenopalatine ganglion blocks. These procedures are considered selectively and are not appropriate for every headache or facial pain condition.
New, severe, worsening, post-traumatic, or neurologically concerning headaches require appropriate medical evaluation before procedural treatment is considered.
Conservative-First, Not Passive Care
A conservative-first approach does not mean waiting without a plan. Evaluation focuses on identifying the most likely pain generator and selecting treatment that is proportionate to the clinical problem.
Before or alongside a nerve block, care may include activity modification, rehabilitation-based strategies, osteopathic manipulative treatment, medication review, ergonomic changes, movement assessment, or targeted exercise progression.
When a nerve block is used, it is typically part of a broader plan rather than a stand-alone solution.
Image Guidance and Procedural Precision
When appropriate, nerve blocks may be performed with ultrasound or fluoroscopic guidance, depending on the nerve, location, anatomy, and clinical indication.
Image guidance can help identify relevant anatomy, improve procedural accuracy, and reduce avoidable tissue trauma. The choice of guidance is based on the specific nerve target and the physician’s clinical judgment.
What a Visit Typically Involves
A visit usually includes a focused review of symptoms, prior treatments, relevant imaging or testing, physical examination, and discussion of whether the pain pattern is consistent with a nerve-related source.
If a nerve block is appropriate, the physician will review the purpose of the injection, expected limitations, alternatives, and relevant risks. In selected cases, diagnostic or therapeutic injection may be performed the same day when clinically appropriate and administratively feasible.
Patients should not submit medical details, symptoms, diagnoses, imaging, medication lists, or insurance numbers through the website appointment form. The online form is for appointment requests only. The office will contact patients to complete scheduling securely.
Frequently Asked Questions
Are nerve blocks used to diagnose pain?
Sometimes. A diagnostic nerve block may help determine whether a specific nerve is contributing to symptoms. The value of the block depends on the clinical context, the accuracy of the target, and how clearly the patient responds.
Can a nerve block treat pain?
In some cases, a nerve block may reduce nerve irritation and improve pain temporarily or meaningfully. Results vary, and response cannot be guaranteed.
Do all nerve symptoms need a nerve block?
No. Some nerve-related symptoms improve with rehabilitation, activity modification, osteopathic treatment, medication adjustment, time, or treatment of a related joint, spine, or soft-tissue problem.
Are nerve blocks the same as epidural injections?
No. Epidural steroid injections are typically used for selected spine-related nerve root pain patterns. Peripheral nerve blocks target specific nerves outside the spinal canal, such as intercostal, genicular, suprascapular, cluneal, or extremity nerves.
Can nerve blocks be performed with ultrasound?
Many peripheral nerve blocks can be evaluated or performed with ultrasound guidance when appropriate. The imaging method depends on the nerve target, body region, and clinical indication.
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