What are non-spinal nerve blocks?

A non-spinal nerve block is a minor procedure to treat or diagnose the source of pain. It relieves irritation from a nerve or group of nerves and allows time for healing. A non-spinal nerve block can improve your pain for several days or longer. This can help you start physical therapy and other rehabilitation programs. You may need a series of injections to maintain results and complete your treatment plan.

Non-spinal nerve blocks involve injecting medicine around a specific nerve or group of nerves outside the spine.  

A non-spinal nerve block is a minor procedure, but it still involves some risk. It is only one method used to treat or diagnose the source of pain. Discuss all of your options with your doctor to understand which options are right for you.  

Types of non-spinal nerve blocks

The types of non-spinal nerve blocks include:

  • Peripheral nerve block, which blocks touch and pain sensations in nerves that supply the skin and muscles of the arms, legs, abdomen, groin, trunk, chest, face and scalp
  • Sympathetic nerve block, which blocks pain sensations in nerves that supply involuntary body functions. Examples include nerves that regulate blood pressure, heart rate, digestion, and sweating.

Why are non-spinal nerve blocks performed? 

Your doctor may recommend a non-spinal nerve block for two purposes:

  • Diagnosing the source of pain. Your doctor will inject anesthetic medicine around a specific nerve or group of nerves. If it relieves your pain, then that nerve is the source of your pain. If it does not relieve your pain, then your doctor will look for another source.
  • Treating pain. Your doctor can inject anesthetic or anti-inflammatory medicine to relieve pain and reduce swelling. This includes corticosteroids. Your doctor can also destroy the nerve fibers that are causing pain with a drug, called a chemical neurolytic, or with an electrical current, called radiofrequency ablation.

In addition, a non-spinal nerve block can control pain so you can start a physical therapy or rehabilitation program with more comfort. 

Your doctor may recommend a non-spinal nerve block for the following conditions: 

  • Acute pain, including injuries that affect nerves
  • Chronic pain, including neuralgias such as long-term pain after shingles (post-herpetic neuralgia) and shooting pain in the lower face and jaw (trigeminal neuralgia) 
  • Excessive sweating, also called hyperhidrosis
  • Pain syndromes, including phantom limb pain and complex regional pain syndrome
  • Pain from blood vessel spasms, including Raynaud’s disease and frostbite

Who performs non-spinal nerve blocks?

The following specialists commonly perform non-spinal nerve blocks:

  • Neurologists specialize in problems of the brain and nervous system, including the spinal cord, nerves, muscles, and related blood vessels.
  • Neurosurgeons specialize in the medical and surgical care of people with diseases and conditions of the brain and nervous system.
  • Orthopedic surgeons specialize in treating problems of the bones and joints.
  • Pain medicine doctors specialize in diagnosing, treating and managing pain and a range of painful disorders.
  • Physical medicine and rehabilitation doctors specialize in muscle, bone, and nervous system conditions that affect physical and mental ability.
  • Rheumatologists specialize in treating arthritis and other rheumatic diseases that cause inflammation and loss of function of the joints, tendons, ligaments, bones or muscles.

Other specialists who perform non-spinal nerve blocks include:

  • Anesthesiologists specialize in preventing and relieving pain.
  • Radiologists specialize in imaging and image-guided procedures.

How are non-spinal nerve blocks performed?

You non-spinal nerve block will be performed in an outpatient setting. It is a minor procedure that involves the following steps:

  1. You will lie on a procedure table in a position that allows your doctor to access the injection site.
  2. You may have a sedative to help you relax, but will remain awake to tell the doctor about your pain.
  3. Your doctor will clean and numb your skin. 
  4. Your doctor may use ultrasound or a special X-ray, called fluoroscopy, to guide insertion of a needle to a specific depth. Image-guidance helps your doctor place the needle as close to the nerve as possible.
  5. Your doctor will inject medicine once the needle is in place.
  6. You will recover for up to 30 minutes and then go home.
  7. You will likely return in about a week so your doctor can evaluate your pain.
  8. You may need to repeat the procedure in a series of injections for maximum benefit.