Therapeutic Nerve Blocks for Neuropathy

Injections of medication close to nerves, known as nerve blocks, relieve neuropathic pain symptoms by disrupting pain signals to the brain.

Short-term relief is provided by injecting a medication into the area in pain. In other cases, a nerve block intentionally damages the malfunctioning nerve or nerves in the area, which offers longer-lasting pain relief.

Medication Offers Short-Term Pain Relief

Injections of medication into the area near a nerve, or group of nerves, can be more effective than oral medication because the medication is delivered directly to the part of the body that is in pain. Medications injected may include steroids, local anesthetics, and opioids:

• Steroid injections may reduce the inflammation and irritation to that nerve and reduce pain.
• Local anesthetics may also break the cycle of pain and provide some relief of the patient’s chronic pain.
• Opioid injections also provide powerful, short-term pain relief.

By reducing irritation, the injections may help the affected nerve, or nerves, heal. Having a nerve block may also improve symptoms enough for the person to take a more active part in physical therapy.

Nerve blocks are used to target pain throughout the body, such as back, neck, head, shoulder, or leg pain. If back pain is the problem, an epidural pain block may be recommended. In an epidural nerve block, a corticosteroid medication is injected into the area around the spinal column known as the epidural space.

See Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica

Nerve blocks are generally most effective when a small number of nerves—or a single nerve—is causing pain. Pain relief is usually immediate. The duration of pain relief varies with the individual, and some people have injections every few months. Pain blocks are typically administered in an outpatient procedure.

Longer-Term Nerve Blocks

In severe cases, a type of nerve block that damages or destroys certain nerves is considered. Various methods are used, all with the goal of preventing pain signals from reaching the brain:

• Neurolytic blocks use injections of chemicals or cryogenic freezing, which involves extremely cold temperatures to damage parts of the nerves.
• Radiofrequency ablation harnesses radio waves to send electrical current to create a lesion on certain nerves.
• A surgical nerve block involves a neurosurgeon removing or damaging specific parts of a nerve or nerves.
• Radiosurgery delivers concentrated radiation to destroy the nerve.

See Radiofrequency Ablation (RFA): Procedure and Recovery

Pain blocks that damage or destroy nerves typically provide longer-lasting relief than pain blocks that inject only medication, but more than one treatment may be needed. Due to the nerve damage involved, this type of procedure is limited to people with extreme symptoms.

Risks of Nerve Blocks

Nerve blocks of any type have a risk of permanent damage to the nerves. Potential risks include, but are not limited to, weakness, muscle paralysis, or lasting numbness. Further irritation and increased pain occur rarely.