How long does a nerve block last?

The immediate effect of local anesthetic lasts hours. When corticosteroid is added, the anti-inflammatory effect may provide relief for weeks to months. For some nerve blocks — particularly occipital nerve blocks for headache — the therapeutic effect can outlast the pharmacological effect significantly, suggesting a neuromodulatory mechanism beyond simple anesthesia.

Is a nerve block the same as an epidural?

No. An epidural steroid injection delivers medication into the epidural space surrounding the spinal cord and nerve roots. A nerve block targets a specific peripheral nerve or nerve plexus outside the spinal canal. Both use image guidance and local anesthetic, but they address different anatomical targets.

Can nerve blocks be repeated?

Yes, within limits. Diagnostic blocks are typically performed once or twice to confirm a diagnosis. Therapeutic blocks can be repeated periodically as needed. If a patient consistently responds well to nerve blocks but the effect is short-lived, radiofrequency ablation of that nerve may provide more durable relief.

Nerve Blocks | Dr. Roslyn Migdale

Overview

A nerve block is an injection of local anesthetic (with or without corticosteroid) near a specific nerve or group of nerves to interrupt pain signal transmission. Nerve blocks serve two purposes: diagnostic — to confirm that a specific nerve is the source of a patient's pain — and therapeutic — to provide pain relief, often lasting significantly longer than the anesthetic itself due to the 'resetting' effect on sensitized nerves. Dr. Migdale performs a broad range of nerve blocks using fluoroscopic and ultrasound guidance.

Types of Nerve Blocks

Dr. Migdale performs diagnostic and therapeutic nerve blocks targeting: occipital nerves (for headache and occipital neuralgia); stellate ganglion (for upper extremity CRPS and certain headache conditions); lumbar sympathetic nerves (for lower extremity CRPS); intercostal nerves (for chest wall pain, post-surgical pain); ilioinguinal and genitofemoral nerves (for groin pain); and selective nerve root blocks at specific spinal levels. Each block is tailored to the patient's specific pain anatomy.

Diagnostic vs. Therapeutic Blocks

A diagnostic nerve block confirms whether a specific nerve is the pain generator. If a targeted injection of local anesthetic provides significant temporary relief, this confirms that nerve's involvement — and guides the next treatment step, which may be longer-lasting radiofrequency ablation or permanent neuromodulation. Therapeutic blocks aim to provide meaningful, sustained relief — sometimes for weeks to months — through the anti-inflammatory effects of corticosteroid and the 'resetting' of sensitized neural pathways.

Image Guidance

All nerve blocks performed by Dr. Migdale use fluoroscopic (X-ray) or ultrasound guidance. Image guidance is not merely preferable — for deep or anatomically complex nerve targets, it is essential for safety and accuracy. Contrast dye is used with fluoroscopy to confirm needle tip position before any medication is injected.

Overview

Types of Nerve Blocks

Diagnostic vs. Therapeutic Blocks

Image Guidance

Frequently Asked Questions