The nervous system in a human being is an extremely complex and delicate structure. When it sustains an injury, whether from an illness or other damaging incident, a neurological expert must be consulted for relief of pain and suffering.
Fortunately, the field of knowledge in neurology and pain management is rapidly expanding. This means new techniques are available to medical providers to relieve suffering from chronic pain conditions.
If you’re in constant pain and can’t get relief, read more about nerve blocks and how they may be able to help you. Our pain specialists are experts in treating chronic pain conditions using innovative solutions that provide significant relief. Nerve blocks can help you by reducing your need for opioid medications to manage your pain.
What is the Nervous System?
In order to understand a bit more about how nerve blocks work, it is helpful to get a basic idea of how the human nervous system operates. The peripheral nervous system and the central nervous system are the components that make up the human nervous system.
The central nervous system is simply the brain and spinal cord. The peripheral nervous system includes nerves and ganglion (a group of nerves) that branch out from the central nervous system (i.e. the brain and spinal cord).
The major function of the peripheral nervous system is to connect the central nervous system to limbs and organs to serve as the relay point between the brain, the spinal cord, and the rest of the body.
The peripheral nervous system also differs from the central nervous system in that the vertebral column and the skull do not protect it. This leaves it exposed to toxins, diseases, and injuries. The peripheral nervous system is divided into the somatic nervous system and the autonomic nervous system.
Three types of peripheral nerves are found within the autonomic and somatic nervous systems.
- Sensory nerves that connect the brain and spinal cord to skin allowing the sensation of pain, temperature, and pressure
- Autonomic nerves that control involuntary functioning such as blood pressure and digestion
- Motor nerves that connect the brain and spinal cord to muscles for voluntary movement
Somatic nervous system: In the somatic nervous system, or voluntary nervous system, the cranial (brain) nerves are part of the peripheral nervous system. The somatic nervous system is involved in the five senses as well as movement of the head, neck, and tongue.
Autonomic nervous system: The autonomic nerve system, which may be thought of as the involuntary system, connects to the internal organs, including blood vessels, stomach, intestines, liver, kidneys, bladder, genitals, lungs, pupils and sweat, salivary, and digestive glands.
The autonomous nervous system is divided into two main divisions:
After the autonomic nervous system receives information from the body or the exterior environment, it answers by either stimulating a response (sympathetic system) or initiating a calming response (parasympathetic system).
It is especially important to know that pain occurs when a sensation is perceived by nerves and then carries that pain signal up to the brain. The brain then translates this signal as a pain signal, which causes you to perceive the painful sensation. With chronic pain conditions, pain signals are constantly traveling up and down these nerve pathways, causing consistent, and oftentimes, intolerable pain.
Solutions for chronic pain conditions target these nerve pathways to either numb the sensation of pain in the affected nerve or to interrupt pain signals before they reach the brain. In either scenario, a chronic pain specialist is skilled enough to know when to use each type of treatment.
Our team of board certified doctors specialize in chronic pain management. We have many years of experience providing innovative treatments that relieve pain and improve quality of life. One of these innovative solutions includes diagnostic and therapeutic nerve blocks.
Nerve blocks are used for pain treatment and pain management. Often, a group of nerves will cause pain and swelling in a particular area that has been affected by trauma or a degenerative condition. This pain can be blocked with an injection of a regional anesthesia which is usually a steroid or opioid or a combination of the two. Nerve blocks provide longer lasting relief than local anesthetic.
Therapeutic nerve block: In a therapeutic nerve block, the injection works to block the nerve from signaling pain and to reduce swelling. This stops the pain signal from traveling up the nerve and to the brain where it is perceived. Once swelling is reduced, the nerve can begin to heal and the pain may improve over time or cease altogether. Nerve block injections may need to be repeated over a period of months for optimum relief.
Diagnostic nerve block: In a diagnostic nerve block, the injection is used to locate which nerves are responsible for the pain. The block involves numbing a specific nerve or nerve group that is likely causing the patient’s pain. Our doctors are experts in anatomy and are highly skilled in noting the location of pain-carrying nerves. This is important because pain originating from different areas of the body requires a nerve block injection in a very specific location.
A local anesthetic is injected in small doses into the target nerves. The patient is then evaluated for any change in pain symptoms. If a nerve is numbed and the patient experiences significant pain relief, the location of the source of the pain is most likely confirmed. If the patient notes no change, the physician may conclude that the painful nerve is in a different location. The injection will be attempted in a new location until the source of the pain is identified.
Types of Therapeutic and Diagnostic Nerve Blocks
Sympathetic nerve block: This diagnostic block is performed to determine damage to the sympathetic nerve chain which is a group of nerves extending the length of the spine. It will be followed by a therapeutic nerve block to manage the pain. These nerves are responsible for the control of several involuntary processes such as blinking and breathing.
The causes of injuries to the sympathetic nervous system are somewhat unclear, but many researchers believe since the pain usually follows trauma to the extremities, the injuries may stem from:
- Damage to blood vessels or nerves
- Some brain injuries
Stellate ganglion block: The stellate ganglion is a collection of nerves at the front of the neck. The diagnostic block is performed to discover where damage has occurred. The sympathetic nerve chain provides sensation to the head, neck, chest or arms. When the source of pain is located, a therapeutic nerve block is performed to manage pain.
Nerve injuries may also be caused by damage from shingles, infectious disease, cancer or persistent angina (chest pain).
A nerve block may also be performed to reduce excessive sweating in the face, head, arms, and hands or to treat chronic pain in the region.
Facet Joint Block: The facet joint block is also known as a zygapophysial joint block. Facet joints are located on the back of the spine where one vertebra overlaps another. These joints both guide and restrict the movement of the spine.
Common Causes of Nerve Damage
The most common cause of damage to the nerves in the neck is trauma, such as whiplash from a car accident. The leading cause of damage to a lumbar spine (lower back) facet joint is aging, but damage can also happen from a sports injury or other physical trauma.
The most common causes of injuries to the peripheral nerve system are medical. This includes conditions such as diabetes, Guillain-Barre, and carpal tunnel or autoimmune disease such as lupus, rheumatoid arthritis, and Sjogren’s syndrome. Other causes of nerve pain include narrowing of the arteries, chest pain after bypass surgery, and tumors.
Different areas of the body require different nerve blocks. Some of the most common areas of the body where nerve blocks are indicated are listed here.
- Trigeminal nerve blocks (face)
- Ophthalmic nerve blocks (eyelids and scalp)
- Supraorbital nerve block (forehead)
- Maxillary nerve block (upper jaw)
- Sphenopalatine nerve block (nose and palate)
- Cervical thoracic and lumbar epidural block (shoulder and upper neck)
- Brachial plexus, elbow, and wrist nerve block (shoulder, arm, hand, elbow and wrist)
- Subarachnoid block and celiac plexus block (abdomen and pelvis)
A successful therapeutic nerve block not only demands the proper technique, but a thorough knowledge and comprehension of how nerves conduct signals, where they are located, and where they start and end. It is also imperative that your specialist has a complete understanding of pharmacology of local anesthetics.
Steroid medication and local anesthetic can prolong pain relief after a nerve block procedure. A variety of methods are now available to prolong relief so that injections are needed less often.
Nerve blocks can either be temporary or longer lasting. Your doctor may give you a local anesthetic after numbing the injection site. He or she can also completely block pain signals by using an ablation procedure to disable nerves. This procedure stops nerves from carrying pain signals for an extended amount of time.
Types of Non-surgical Nerve Blocks
- Epidural analgesia or anesthesia - the doctor injects medicine outside the spinal cord
- Spinal anesthesia or analgesia - the doctor injects medicine in the fluid surrounding the spinal cord
- Peripheral nerve block - the doctor injects the target nerve, which is responsible for the pain
What to Expect During a Nerve Block Procedure
Your doctor will administer a local anesthetic to numb the injection site. You’ll feel a slight pinch or mild discomfort as the needle pierces the skin. The needle will be guided by an ultrasound or fluoroscopy, which converts X-rays into video images. This allows your doctor to inject the medication in precisely the right spot.
The procedure itself takes anywhere from 5 to 20 minutes, depending on your specific treatment needs. It will take another 15-45 minutes for full pain relief. The amount of time it takes will depend on the medication used and your individual response to the medication.
Nerve block procedures are universally considered very safe when performed by a medical doctor. However, there are always risks with any medical procedure.
Possible risks include:
- Raised blood sugar levels from the steroid
- Nerve damage causing loss of sensation or loss of strength
- Very rarely: muscle weakness or paralysis from damage to the spinal cord or major nerve
When Nerve Blocks Work Best
Nerve blocks work best if the pain is related to a single nerve or a small nerve group. While therapeutic nerve blocks can bring much-needed relief, they usually do not cure the pain forever. The effects of the block are not permanent.
Nerve blocks can be an essential part of a complete pain management program that may include oral medications, exercise, physical therapy, and stretching to help with recovery.
Diagnostic & Therapeutic Nerve Blocks in Torrance
Noting the complexity of the human body and nervous system, anyone can appreciate the years of comprehensive medical training it takes to become an expert at understanding the nervous system. Our specialists can help you understand your extent of nerve damage, what you need to heal, and what kinds of treatment options may work best for you.
Pacific Pain and Wellness Group in Torrance, CA offers a team of board certified doctors who specialize in pain management. They have years of experience performing diagnostic & therapeutic nerve blocks for pain relief.
No one should suffer from an unmanaged chronic pain condition. To learn more about what we can do to manage your pain and get you back to the life you love, get in touch with us today at (310) 437-7399 to book your consultation.
At Pacific Pain & Wellness Group, we care about you as much as you do. Because when you feel better, you can live better.