Nerve Blocks

NERVE PAINS

Nerves send pain signals from your body to your brain. There are various nerves that can be blocked to help you get pain relief in the following areas.

HEADACHE

A headache in the back of of your head, often shooting up the occiput, is called  occipital neuralgia. This can be caused by entrapment of the greater and lesser occipital nerves. It can be also caused by arthritis at the C2, C3 vertebrae, for which we would consider a different treatment.  Be sure you learn how to stretch your neck muscles  (for example: trapezius, scalenes, cervical paraspinal muscles) prior to considering an injection and assess why the nerves are irritated. Botox may be considered for migraines.

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HAND PAIN

Carpal Tunnel Syndrome treated by a median nerve block using ultrasound guidance. Remember to wear your wrist brace every night if you have carpal tunnel. You need to give that nerve a break from compression.  Also be sure to check your ergonomics: how do you type, drive, do your daily activities?

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SHOULDER PAIN

The shoulder joint is very complex and is made of various joints. One of the nerves that can be blocked, in addition to injecting the joint themselves, is the suprascapular nerve.  Joint strengthening and mobilization should be considered prior to blocking your pain. Regenerative medicine can be considered for tendons (ex. rotator cuff syndrome) and joint capsule.

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KNEE PAIN

To prevent a total knee replacement, or to treat pain after having a replacement, we can consider genicular nerve blocks. If these genicular nerve blocks give you pain relief, we can then consider a genicular nerve radiofrequency ablation, where these nerves are treated at 80 degrees C, reducing pain.  For the arthritis patient, note that even 5-10lbs of weight loss will improve your pains significantly. Knee steroid injections and regenerative medicine injections can also be considered.

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VAGINAL PAIN

The vaginal/pelvic region is innervated by the pudendal nerves. Pudendal neuropathy can be treated with pudendal nerve block with fluoroscopic guidance. I go through the buttock (not the vaginal walls) to target these nerves using xray guidance.  Be sure to go to your OBGYN and urologist to rule out any serious issues.

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GROIN PAIN OR LOWER ABDOMINAL PAIN

The ilioinguinal and genitofemoral nerves can get irritated, and cause lower abdominal or groin pain. These nerves can be blocked using ultrasound guided procedures.  Before getting these nerves blocked, talk to your doctor about why you may be having these pains.

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THIGH PAIN

The Lateral Femoral Cutaneous Nerve can get irritated, causing Meralgia Paresthetica. This nerve can get entrapped by a ligament, called the ilioinguinal ligament (IL), which is located by the crease where the thigh meets your abdomen.  This nerve entrapment can occur in athletes, post-surgical (ex. hernia repair) patients, obese patients. If obesity is the cause, then a healthy diet is the first thing to be considered.  We can also consider an ultrasound-guided injection to reduce your pain.

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