For many people who suffer with severe pain, nerve blocks have become part of their treatment. These injections of local anesthetic and steroid directly to the area of the affected nerve can help with pain control and improve function and quality of life. Often, the goal is to help people avoid surgery and to take an active role in physical therapy.
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Pain management specialist Paul Shin, MD, offers insights for patients considering having a nerve block. He says your doctor will help you determine the best procedure for the pain you have, but in general, here are four things to expect if you have a nerve block.
1. Fear of the injection is almost always worse than the injection itself
Patients are often hesitant when it comes to needles. Some procedures for arthritic conditions may involve up to six needles, but most procedures are well tolerated and brief. Generally, they only last five to 15 minutes. A local anesthetic or even IV sedation are sometimes used.
A fluoroscope, or low powered x-ray, allows whoever administers the nerve block to visualize the bony structures. This enables accurate placement of the needle and reduces complications. You’ll spend most of your time preparing and recovering from the procedure afterwards.
2. Everyone responds differently to a nerve block
For some people, a nerve block gives immediate relief. For others, it takes a series of injections before it helps the pain. It’s very unpredictable. This is because pain is a personal perception and everyone responds differently.
Also, if you have had chronic pain for 10 or more years, it could involve multiple pain generators. There are many anatomic structures and the pain could come from more than one joint or nerve. In the spine, it’s possible that your first injection will take away some of the pain but that other injections will offer more improvement.
This also means that the sooner you can get an injection before your pain becomes chronic, the better your result. In addition, injections are typically combined with other forms of treatment such as physical therapy to increase your chances of getting better.
3. You might have some post-procedure soreness
You can expect some post-procedure discomfort or soreness that will also improve within days of the injection. The local anesthetic doesn’t last long and for some people, it may take a while for the steroid to work and provide a long-term benefit.
The peak effect of the steroid will usually be between three and 10 days. It is slowly released into the body, and for some people, there is an interval before you start to feel the improvement. Your response to the first injection helps guide your doctor about future treatments as he or she works to pinpoint the nerve that is causing your pain.
4. Your injection frequency depends on your medical history
Based on your medical history and physician preferences, you can usually repeat this procedure from three to six times in a 12-month period. Medical conditions, such as diabetes, will mean that your doctor will need make injections less frequent. Your doctor will determine the exact number of injections that you can receive.
Ultimately, the goal of nerve block injections is to decrease pain, increase your function and, for some patients, allow more aggressive physical therapy. They work well for many patients.
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