Peripheral Nerve Blocks Procedure for Pain Management
Peripheral Nerve Blocks
Treatment Overview
Peripheral nerve blocks are an effective pain management technique that targets specific areas by injecting a local anesthetic steroid near a nerve or cluster of nerves. This method interrupts pain signals to the brain and can be used to diagnose and treat chronic conditions like peripheral neuropathy, complex regional pain syndrome and neuralgia.
Peripheral Nerve Block Techniques
The peripheral nervous system is like a tree with the spinal cord as the trunk and peripheral nerves as branches extending into the arms, legs and other body parts. Nerve blocks involve placing needles near the painful nerve using ultrasound or X-ray imaging. Medications, such as local anesthetic-steroid mixtures, are injected to numb the nerve and reduce inflammation. This can help the nerve heal and become less hypersensitive, while steroids can directly address nerve inflammation.
Femoral-Obturator Nerve Block
The femoral nerve is one of the largest nerves in the leg. It’s located near the groin and controls the muscles that help straighten the leg and move the hips. The obturator nerve comes from the lumbar plexus and helps you move and feel your inner thigh.
A femoral-obturator nerve block is used to treat chronic hip pain, which may occur after hip surgery or trauma. The procedure may provide pain relief for individuals with chronic hip pain after successful hip replacement and can be repeated to manage chronic hip neuralgia. With the femoral-obturator nerve block, the doctor injects a mix of anti-inflammatory steroids and local anesthetic around the nerves that connect to the hip joint.
If blockade of these nerves relieves pain in the short term, radiofrequency nerve ablation of the femoral-obturator nerves may be recommended for long-term pain relief.
Genicular Nerve Block
The genicular nerves are located around the knee joint and play a key role in transmitting pain signals from the knee to the brain. These nerves can become a source of chronic knee pain, particularly in conditions like osteoarthritis or after knee surgery.
A genicular nerve block involves injecting a combination of a local anesthetic and an anti-inflammatory steroid near these nerves to relieve pain. The procedure is performed under imaging guidance to ensure precision. This nerve block can offer temporary relief and is often used to determine if the genicular nerves are contributing to the pain, potentially leading to more long-term treatments like Radiofrequency Ablation (RFA) if successful.
Genitofemoral Nerve Block
The genitofemoral nerve refers to a nerve that is found in the abdomen. The genitofemoral nerve block may provide pain relief for patients with groin, perineal, testicular or vaginal pain and can be used repeatedly to manage chronic neuralgia. The procedure is also used to treat genital pain — often after hernia surgery or trauma to the groin. Sometimes, genitofemoral and ilioinguinal nerve blocks (see below) are combined to offer relief to a wider area.
With the genitofemoral nerve block, the physician injects an anti-inflammatory steroid and local anesthetic mixture around the nerve using ultrasound or fluoroscopy to maximize accuracy.
Ilioinguinal Nerve Block
The ilioinguinal nerve originates from the first low back (lumbar) spinal nerve. This nerve wraps above the upper ridge of the hip bone and travels into the groin, providing sensation to the inner thigh, groin and perineum.
Individuals with ilioinguinal neuralgia may experience pain in the lower portion of the abdomen and pelvis, into the groin and genitals. Ilioinguinal neuralgia is one of the most common causes of lower abdominal and pelvic pain. Its main symptoms include burning pain and numbness over the lower abdomen that radiates to the genitalia and into the inner thigh.
The ilioinguinal nerve block is used to treat this pain, though sometimes ilioinguinal and genitofemoral nerve blocks are combined to cover a broader area of the groin.
Intercostal Nerve Block
The intercostal nerves are located under the ribs and provide sensation to the back and chest. Intercostal nerve block procedures are performed to help diagnose or treat pain from shingles, rib fractures or past surgical incisions in the area.
With an intercostal nerve block, a local anesthetic and steroid medication is injected into the region just beneath one or more ribs. Individuals may experience significant pain relief immediately after the injection — how long that relief lasts depends on the person and the pain. Depending on the degree and duration of pain relief you receive, your doctor may recommend that the block be repeated to offer ongoing relief.
Lateral Femoral Cutaneous Nerve Injection
The lateral femoral cutaneous nerve provides sensation from the groin to the top of each thigh. If the nerve is pinched or injured, it can cause pain, numbness, tingling or painful stinging in the front or outer part of the thigh. Lateral femoral cutaneous nerve blocks are a minimally invasive, non-surgical injection for chronic pain in this area.
During this injection, a small amount of numbing medicine — often combined with an appropriate corticosteroid — is injected around this nerve. These nerve blocks often help diagnose chronic hip or thigh pain. If the injection significantly alleviates discomfort, the block may be repeated to provide ongoing relief. In some cases, one injection is all you will need.
Occipital Nerve Block
The greater occipital nerve controls most of the sensation in the back and top of your head. If this nerve gets irritated, it can cause headaches. These headaches often start at the base of the skull and spread to the temple, forehead and behind the eyes.
An occipital nerve block treats this type of pain — particularly migraines and chronic headaches. This procedure involves injecting a local anesthetic and steroid into the occipital nerves at the base of the skull, reducing swelling and the discomfort it causes. Pain relief can be immediate and lasting, but if it returns, the procedure can be repeated with physician approval.
Who Benefits from Peripheral Nerve Blocks
What to Expect
- Preparation: The procedure is performed at our same-day surgery center and does not require an overnight stay. You’ll change into a surgical robe and may receive sedation or local anesthesia.
- Procedure: Your provider will use imaging techniques to guide a needle to the area around the targeted nerve. An anesthetic medication, often combined with a steroid, is then injected to block pain and reduce inflammation.
- Recovery: After the procedure, you’ll be monitored briefly. Any mild soreness can be managed with over-the-counter pain medication.
Insurance & Billing
Your eligibility for any procedure depends on the benefits outlined by your insurance provider, and our team at Nura will assist you with the authorization process.
Comprehensive Care
At Nura, we seamlessly integrate interventional procedures, physical therapy, psychological support and medications. Research shows that this comprehensive approach is the most effective way to manage chronic pain.
Find Pain Relief
Schedule an appointment with one of our pain specialists by filling out our appointment request form or giving us a call at 763-537-6000.
