Pain Management: Types of Pain Management Blocks

pain management blocks

Pain Management

Types of Pain Management Blocks

Celiac Plexus Blocks

To understand what a celiac plexus block is, one must have an idea of what is the celiac plexus. By definition, the celiac plexus is a complex network of nerves that is located in the abdomen where the arteries branch out from the abdominal aorta. These nerves send (transmit) pain signals from the abdomen to the brain.

A celiac plexus block is an injection of a local anesthesia at the area of the celiac plexus. It is recommended for diagnosis or relief of abdominal pain that may be due to chronic pancreatitis or any type of cancer involving the abdominal area.

It is performed under sterile conditions. Your anesthesiologist will numb the insertion area to facilitate injection. During administration of the nerve block, a slight burning sensation may be felt. An immediate pain relief is expected post-injection.

Lumbar Sympathetic Blocks

A lumbar sympathetic nerve block is a procedure that involves injection of a local anesthetic in the lumbar area of the back where the sympathetic nerves are located. The lumbar sympathetic nerves transmit information from the lower extremities through sympathetic nerves.

Problems associated with lumbar sympathetic nerves often cause burning/pain sensations and sensitivity changes in the leg or foot. A lumbar sympathetic block injection temporarily turns these nerves off to diagnose or relieve lower extremity pain, swelling, and other leg or feet problems.

The sympathetic block procedure is usually done in few minutes. There are times when a live X-ray is used to guide the needle during insertion. If an x-ray is done, the procedure may take 30 minutes or more.

Stellate Ganglion Blocks

A stellate ganglion is a bundle of sympathetic nerves found at the last vertebra of the neck. The nerves on this bundle are grouped in a star shape and are part of the nervous system that supply the face and arm.

Stellate ganglion blocks work like other nerve blocks – numbing the nerves and blocking the pain signals being sent to the brain.

By definition, a Stellate ganglion block is an injection of a local anesthetic to a specific area in the neck through sympathetic nerves pass. These nerves are connected to the head, arm, hand, neck and chest.

Medial Branch Blocks

Medial Branch Block, also called “Facet Joint Nerve Block”, involves injection of a local anesthetic to temporarily numb the nerve supply on the area of the facet joints. The facet joints are situated at the back of the spines where one vertebra overlaps the next. These joints provide spine stability and flexibility.

The Medial Branch Block helps diagnose or treat lower back pain. The injection, which contains local anaesthetic, numbs the nerves that supply the facet joints, resulting to short-term pain relief if the pain is due to disturbances involving these nerves.

Nerve Root Blocks

A nerve root is a portion of the spinal nerve that passes through the bony canal, leaving at each vertebral segment of the spinal cord. They serve as pathways that send communication between the body and the brain.

Nerve root blocks are procedures that involve injection of a local anaesthetic with a hydrocortisone around a spinal nerve root. This is performed when a specific nerve in the

lower back is swollen due to irritation from either a disc problem or stenosis (narrowing) of the

spinal canal. It can be a result of aging (degenerative wear and tear).

This procedure is not a cure, but a symptom relief for back pains as a result of inflammation secondary to an irritation or impingement of the nerve.

Occipital Nerve Blocks

The occipital nerves are the nerves that travel from the neck to the back of the head and scalp. These nerves are sensory by nature and originate from the base of the brain to the area behind the eyes and sides of the head.

Injection of a local anaesthetic and steroid around these nerves is termed as Occipital Nerve Block. This procedure aims to decrease nerve inflammation, block or inhibit pain signals that are sent to the brain, and relieve headaches.

Peripheral Nerve Blocks

The term peripheral nerve is identical with the peripheral nervous system. The main function of the peripheral nervous system is to connect the brain and spinal cord to the limbs and organs. It carries signals of sensations and movements such as pain, heat and cold.

A Peripheral nerve block is a procedure of injecting anesthetics in an area directly around specific peripheral nerves to block the transfer of pain signals from the area it supplies to the brain. This can be used to manage chronic pain or neuralgia (pain arising from a nerve) in various regions/areas of the body. They can produce prolonged pain relief and decrease the need for daily oral pain medications.

Side Effects from Pain Blocks

Although any type of nerve block is generally safe, no medical procedure is risk free. They do have side effects and risks which may or may not include the following:

  • Soreness at the injection site
  • Redness or rashes
  • Itching
  • Bruising at the injection site
  • Weight gain
  • Increase in blood sugar levels
  • Bleeding at the injection site
  • Death (rare cases)

A doctor’s advice is necessary before deciding to undergo a nerve pain procedure.