Nerve blocks at Edinburgh Hospital

What is a nerve block?

A nerve block involves injecting medication, usually a local anaesthetic, right next to a nerve or a cluster of nerves. Doing this brings short-term relief from pain, and can also help pin down exactly where that pain is coming from.

What conditions does a nerve block treat?

Nerve blocks can be used for a wide range of pain, including:

• ongoing conditions such as sciatica, complex regional pain syndrome, or migraines that keep recurring
• pain connected to cancer, including pancreatic tumours or long-term pancreas inflammation
• labour and childbirth
• sudden injuries, including fractures, dislocations or wounds, particularly within emergency care
• the period around surgery, sometimes paired with or used instead of a general anaesthetic for smaller operations.

What are the benefits of a nerve block?

Nerve blocks serve three main purposes: easing pain whether it flared up suddenly or has lingered a while, pointing towards where pain originates (feeling better after the injection suggests that particular nerve is behind it), and supporting comfort around surgery, sometimes cutting down how much other anaesthetic or pain medicine you end up needing.

For certain smaller operations, choosing this route instead of being put fully under can bring a swifter bounce-back and reduce what you need to take once you're home.

Are there different types of nerve blocks?

• Epidural block, easing pain through labour and childbirth, or applied during certain surgical procedures.
• Lumbar sympathetic block, targeting pain running through the lower back and down the leg, sciatica among the causes.
• Occipital block, aimed at headaches felt towards the back of the skull, migraine included.
• Stellate ganglion block, addressing pain in the head, neck or arm, while also boosting blood flow through the arm.
• Coeliac plexus block, aimed at pain stemming from pancreatic cancer or ongoing pancreas inflammation.
• Pudendal block, easing pelvic pain, or standing in for an epidural during childbirth.

Hundreds of different nerve blocks exist across the body, and your healthcare provider will suggest whichever fits your particular pain best.

What happens before a nerve block?

There's typically nothing special required of you beforehand. Where sedation forms part of your procedure, going without food for 6 to 8 hours in advance becomes necessary, along with organising a lift home once it's done.

Let your care team know if you're on anything that thins the blood, aspirin, warfarin or clopidogrel included, since this might need pausing for several days beforehand.

What happens during a nerve block?

1. You're positioned so your provider can easily reach the site needing treatment; a mild sedative through a drip is sometimes offered to help you settle.
2. Your skin gets cleaned, then numbed with a local anaesthetic injection; expect a brief sting or twinge as the needle goes in.
3. Scanning technology, ultrasound or X-ray for example, or a small gadget that triggers a twitch in nearby muscles, helps your provider locate the precise nerve involved.
4. The medication then goes in as near to that nerve as achievable.
5. A short period of rest follows, giving the medication time to start working.

This is generally handled as an outpatient visit, meaning there's no hospital admission involved and you head home the same day.

What does recovery look like?

Once the injection's done, you will rest for 15 to 30 minutes, with staff keeping an eye out for anything unwelcome cropping up.

Passing urine is usually needed before you're free to leave, and since driving yourself or catching public transport aren't options right after, having a friend or relative on hand to collect you makes sense.

Just how long the benefit lasts differs enormously from person to person, sometimes only a handful of days, other times stretching into weeks, months or beyond. Some feel genuinely different after just one visit, others need it repeated to feel the effect, and for a few, nothing changes at all.

What are the risks and complications?

Possible risks of a nerve block include:

• infection or bleeding where the needle went in
• the medication ending up in a blood vessel by accident
• it travelling further than planned, into neighbouring nerves or the spinal canal
• a patch of numbness or weakness that lingers in the treated area
• effects tied to the particular block used, a hoarse voice or difficulty swallowing after a stellate ganglion block for instance, or blood sugar climbing temporarily if you have diabetes
• on rare occasions, a serious allergic reaction to the medication used.

Get in touch with your healthcare provider if new symptoms crop up afterwards, worsening burning sensations, weakness, tingling, or anything suggesting infection.