Nerve Blocks

A nerve block, an anesthetic injection, is used in the management of severe pain. Nerve blocks are not only used to reduce pain and inflammation but also as a pointer for identifying specific source of pain. It involves injection of a local anesthetic to specific nerves. When regional anesthesia is needed for surgery, a nerve block is often used to numb the targeted set of nerves. In surgical cases, a 'nerve catheter' might be placed to continually supply the nerves with numbing medication and prevent severe pain to the patient. Nerve blocks are more effective than IV anesthetics.

Nerve blocks are used in cases of severe pain such as Raynaud's syndrome, chronic abdominal pain, severe back pain and reflex sympathetic dystrophy. This procedure is done with imaging guidance from fluoroscopy, ultrasound or CT. It allows the radiologist to view the needle movement and guide it to the right location. Soon the patient experiences numbness and pain relief. A nerve block works by blocking or reducing the signals sent to the brain. The risks of bleeding, infection, nerve injury and allergic reaction are associated with nerve block injections.

Reflex Sympathetic Dystrophy

Reflex Sympathetic Dystrophy (RSD) involves severe pain, inflexibility, inflammation and discoloration of the hand or leg. Women are more likely to suffer this complex regional pain syndrome or RSD. They experience burning pain, spasms and weakness in the limbs and are unable to move them. It can affect any limb but it is commonly associated with the hand thereby severely restricting shoulder-hand movement.

In the initial stage (Stage 1), there is increased warmth and inflammation accompanied with excessive sweating and pain of that particular part/limb. Stage 2 or dystrophic Stage involves increased swelling, brittle nails and wrinkled appearance of the affected part. During the atrophic stage or Stage 3, there is a dehydrated and pale appearance in the affected limb.

Injuries to the soft tissue, bone or nerves, surgery or other health conditions can trigger this kind of dystrophy. Bone scans and X-rays help in diagnosis. Thermography is also used to check blood flow to the affected limb. This condition must be differentiated from other similar syndromes such as rheumatoid arthritis and scleroderma.

Mild cases of RSD are treated with NSAIDs. As the condition worsens, stronger medication must be supplemented with suitable pain management such as physical therapy. Bisphosphonates, calcitonin, regional nerve blocks and dorsal column stimulation can provide relief.