To effectively treat chronic pain, we sometimes need to remove or block the cause of the pain. A nerve is thought to be the cause of pain. Pain at the nerve may be treated in a variety of ways. The nerve might be destroyed by certain operations, while in some cases the nerve will be blocked. Nerve block and radiofrequency denervation, another name for nerve burning, and the pros and cons of nerve burning and nerve block will be discussed in this article.
When other therapies have failed, a nerve block or nerve burning provides a safe, less intrusive option to pain management.
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What is Nerve Burning?
Identifying the cause of the pain and isolating the affected nerves is the first stage in nerve burning. Next, a local anesthetic is injected into the affected area to perform a nerve block. It is possible to assess how much relief will be offered by numbing the nerve and even how the affected area will feel after destroying the nerve. Physicians may consider destroying the nerve if the amount of pain reduction is sufficient and the residual feeling is not unpleasant.
Pros and Cons of Nerve Burning
Following are some of the pros and cons of Nerve Burning:
Pros of Nerve Burning
1. Minimally Invasive Procedure
Nerve burning or RFA is an outpatient non-surgical procedure that is performed under local anesthetic or intravenous sedation. Most patients are able to return to work within a week or less after the procedure is completed.
Nerve burning is a minimally invasive procedure that is both safe and improving in terms of technology.
2. You can recover in No Time
While other operations need months of recovery time, RFA does not and most patients may return to their daily routines in much less time. Since no incisions are required, this treatment has a lower risk of infection.
Additionally, imaging tools such as fluoroscopy X-rays and ultrasound scans lower the chance of significant blood vessel injury.
3. Long Lasting Pain Relief
85 percent of patients reported pain alleviation lasting up to two years after therapy, on average, after four to six months. More than half of patients who had nerve-burning or RFA treatment two years earlier reported a significant reduction in pain.
Cons of Nerve Burning
1. Side Effects are Possible
RFA has fewer side effects than chemical sympathectomy, however, it is not completely risk-free. The following are some of the possible side effects of this treatment:
- Itching or numbness
- Inflammation of the neck glands.
- Muscle aches and pains.
2. Not for all kinds of Pain
Patients with back/leg pain or pain trigger points may not benefit from ablation treatment, which may cure most kinds of neuropathic pain such as nerve pain resulting from cancer injury or drug overuse syndromes.
3. Nerve Damage is permanent
Post-treatment, paralysis may preclude some people from ever driving again because of the lack of sensation. Young people who have family obligations may find this particularly difficult, given that they are unable to drive while they recover.
What is a Nerve Block?
It is a procedure that stops nerves from delivering pain signals to the brain by using a numbing drug and, in certain cases, an asteroid. This is a minimally invasive procedure that is often utilized when your discomfort hasn’t responded to previous therapies and you aren’t ready to undergo surgery. It’s also a viable therapeutic choice for those who aren’t surgical candidates.
A nerve block may be used as a diagnostic tool in addition to treating pain after surgery, acute pain, and chronic pain.
This technique may be recommended if your doctor feels that pain signals are coming from a specific nerve or group of nerves. You could be a suitable candidate for radiofrequency ablation (nerve burning) if your pain is effectively alleviated following this. If the pain persists, it is unlikely that those nerves are the source of your discomfort.
Benefits of Nerve Block
The nerve block is used to treat a wide range of pain disorders, which includes:
- Chronic headache
- Complex regional pain syndrome
- Joint pain
- Phantom limb pain
- Pre- and post-surgical pain
They’re also often utilized as a therapy option when your health or other circumstances prevent you from having surgery. A nerve block may also be used as a diagnostic tool, or for motivating your doctor to investigate other possible reasons for your discomfort.
Nerve blocks have a lot of studies backing them up, regardless of how they’re used.
Peripheral nerve blocks reduced pain by at least 50% in the great majority of research participants with chronic pain, according to a 2019 study. Importantly, following their nerve block, these individuals reported a better quality of life.
In a 2018 study of trigeminal neuralgia, all individuals were pain-free immediately after the block, and many of them stayed pain-free for up to eight months.
The prognosis for knee and hip replacement patients is significantly better. After analyzing nearly a million patients, researchers determined that patients who had nerve blocks during knee and hip replacements had better results than those who did not. There were fewer complications, and hospital stays were reduced or eliminated totally.
Different Types of Nerve Blocks
There are many methods that are generally associated with the site of pain in your body. There is one notable exception in the form of a nerve block, which is more often employed.
Nerve blocks of this sort are the most prevalent.
1. Occipital Nerve Block
The cervical spine is where your occipital nerve begins. Migraine headaches, as well as discomfort on the sides of the head and around your eyes, may be caused by damage or injury to this nerve.
This discomfort may be relieved by an occipital nerve block, which is commonly given between third and fourth vertebrae.
2. Genicular Nerve Block
Genicular nerves are found in the vicinity of your knee joint and surrounding it. When the knee joint is compromised, either by injury, trauma, or plain wear and tear, these nerves produce pain signals. A genicular nerve block is used to alleviate a variety of pains, including knee discomfort after knee surgery.
People with persistent knee pain who are not candidates for knee surgery benefit greatly from this sort of nerve block. Other therapies, such as physical therapy, may be used in conjunction with a genicular nerve block to lessen overall discomfort.
3. Trigeminal Nerve Blocks
On both sides of the head, the trigeminal nerve is positioned immediately in front of the ears. The jaw, nose, cheeks, forehead, and skull, are all innervated via its branches. Damage to the trigeminal nerve causes some of the most difficult-to-treat face agony, known as trigeminal neuralgia.
Something as simple as a wind might cause pain to originate from the trigeminal nerve. While the underlying causes are investigated and addressed, a trigeminal nerve block may provide relief.
4. Pudendal Nerve Block
Beginning in the rear of the pelvis, the pudendal nerve branches out in 3 directions from the sacrum. The rectum is served by one branch, while the perineum and genitals are served by the other two.
A pudendal nerve block may benefit those who are suffering from pelvic discomfort. This pain might be caused by an illness known as pudendal neuralgia, or it can be caused by an injury to the area during delivery or other trauma. Pain may also be caused by tumors or cysts pushing on this nerve. During surgery on this part of the body, a pudendal nerve block may be used.
5. Intercostal Nerve Block
The intercostal nerves are found between the ribs and in the gaps between them. The whole diaphragm, including your upper chest, abdomen, muscles, and skin, is supplied by these nerves. Conditions like shingles, surgery, and any other postoperative discomfort may also cause pain.
An intercostal nerve block injection provides relief for many people after only one therapy. This makes it easier for the body to mend and recover.
6. Peripheral Nerve Block
The Peripheral nerves provide movement, sensation, and motor control to the whole body. A peripheral nerve block may help to relieve pain in a greater area of your body.
Peripheral nerve blocks are used to target the nerves that cause pain in a specific location of the body. An excellent example of a peripheral nerve is the sciatic nerve. It begins in the lumbar spine and travels all the way to the buttocks, down the hip, leg, and foot. A sciatic nerve peripheral nerve block may help with pain and other symptoms.
Surgical operations may also benefit from peripheral nerve blocks. According to research, if your anesthetic plan has a peripheral nerve block, you may recover more rapidly from some procedures in the near term.
A continuous catheter nerve block may be recommended by your doctor if you have persistent discomfort in your peripheral nerves. They’ll insert a catheter beneath the skin near to the afflicted nerves to give ongoing treatment instead of a single injection
7. Stellate Ganglion Block
Nerve blocks to the stellate ganglion may be used to diagnose as well as relieve pain. This nerve group is responsible for providing sensation to the arms, chest, neck, and head, and it may be utilized to assess (and occasionally alleviate) pain in the region.
This injection is given via the front of the neck, close to the voice box, into the stellate ganglion nerve.
Celiac plexus blocks for stomach discomfort and brachial plexus blocks for the pain in the hands, arms, and shoulders are among the additional nerve blocks available
What to Expect in a Nerve Block Procedure?
The nerve block procedure is performed as an outpatient operation. Many individuals simply need a local anesthetic, but if you’re worried about the surgery, talk to your physician about a moderate sedative. This might be a little IV sedative or in the form of an oral drug.
When you’re ready, place yourself on the examination table so that the injection area is easily accessible. This will differ. A stellate ganglion block, for example, is given at the front of the neck, whereas an occipital block is given at the rear.
The spot will be cleaned and sterilized by your doctor. Regardless of sedation, your doctor will numb the region with a local anesthetic. Initially, you may feel a pinch or sting, but this will fade as the region goes numb.
Your doctor inserts a tiny needle in the region above the nerve being targeted using X-ray guidance. They inject a modest bit of contrast dye initially to ensure the needle is properly positioned. Depending on your treatment plan, your doctor may inject a numbing drug, asteroid, or both after verifying the location.
Although you may get many injections, the total treatment takes less than an hour.
Recovery After Nerve Block Procedure
Following your nerve block, you will be sent to a recovery area where you will relax for a brief while. This time frame is generally between 15 & 30 minutes if you did not get IV sedation.
If you had IV sedation, you must go home after your treatment.
After your procedure, take a day off. Although your physician will give you specific instructions for recovering after a nerve block, here are some basic guidelines:
- Take it easy on the day of the procedure
- The next day, resume normal activities when you feel able
- Unless your doctor tells you differently, take all of your normal prescriptions.
- Maintain a healthy diet.
There may be some bruising and pain at the injection site. NSAIDs (nonsteroidal anti-inflammatory medicines) may assist with both of these issues. An ice pack may also give relief from pain and swelling.
Side Effects of Nerve Block
The following are some of the possible nerve block effects:
- Increase in pain
- Injury to the nerve
- Spinal headache
- Muscle weakness
When the block is done under X-ray (fluoroscopic) supervision, the adverse effects and hazards are reduced. Following your doctor’s nerve block recovery recommendations may also assist ensure complications.
If you see a sudden, prolonged rise in discomfort, or if you notice evidence of infection at the block’s location, consult your doctor.
Pros and Cons of Nerve Block
These treatments are minimally invasive, which means they may help you avoid surgery. The majority of persons have little, if any, adverse effects. When side effects do occur, they are typically minor and transient. After only one block, many patients receive long-term pain alleviation.
However, not everyone reacts favorably. Relief may last just a few hours or may not occur at all. Some patients need many injections at various nerve locations.
Additionally, if the nerve blocks contain a steroid, the number of times you may have an injection becomes limited (Not more than 4 times per year)
Frequently Asked Questions (FAQs)
Is nerve burning painful?
A scorching, shooting or stitching sensation can be related to nerve burning. At times, it might be as quick and intense as an electric shock.
Does burning a nerve work?
Radiofrequency nerve ablation is 70% to 80% effective in those who have undergone successful nerve blocks. Pain alleviation might continue anywhere from nine months to two years following 10 days of treatment.
What if a nerve block doesn’t work?
Well, it is hard to accept that it won’t work. However, no pain alleviation indicates that the targeted nerve isn’t the source of your suffering when a nerve block is employed as a diagnostic technique. If this occurs, you and your doctor will talk about what you need to do next to get a diagnosis.
For how long does the nerve block procedure last?
Every person goes through different pain. Therefore, the consequences of a nerve block differ. Most patients have pain alleviation right after the initial nerve block, with the pain returning when the local anesthetic loses effectiveness. This is completely normal and anticipated.
Within a few days, after the local anesthetic wears off, you may have pain relief. When your pain is decreased by at least 50%, a nerve block is deemed effective, and this may take up to 2 weeks to complete.
The duration of pain alleviation is also dependent on the individual getting the block.
Some people get pain relief for just a few hours, while others remain pain-free for months. Discuss your options with your doctor, taking into account the underlying cause of the pain as well as any other medical issues you may have.
Why should you have a nerve block?
During and after surgery, a nerve block relieves discomfort. It is more effective than using an IV to provide pain medicines. Even if you have the meds accessible to you, you will need IV or less oral pain medications since you are in less pain. Pain drugs’ adverse effects, such as somnolence, nausea, itching, and respiratory depression, will be reduced. Furthermore, you might be able to avoid undergoing general anesthesia. For pain treatment following surgery, a nerve block is sometimes used in conjunction with general anesthesia.
Is a nerve block safe?
Nerve blocks, like general anesthesia, provide certain minimal risks. Because the surgery is performed in a sterile environment, the danger of infection is quite minimal. Nerve damage is a very rare occurrence (0.1 percent), and it is typically just temporary.
Does having a nerve block hurt?
The procedure is performed by inserting a needle little larger than an IV into the nerves that feed the area of the body that is being operated on. When doctors do a nerve block, they give all patients sedative medication to help them relax.
Is the patient awake during the operation?
The area to be operated will be numb for a nerve block. Many times, you have the option of being as awake or as drowsy as you desire. Because a big sterile drape is usually put between you and the surgeon, you never get to watch the procedure itself.
How long does a nerve block last?
Well, this varies depending on the kind of block and the numbing medicine utilized. Nerve blocks for hand surgery, for example, typically last 6-8 hours, but nerve blocks for discomfort following total knee replacement may last 12-24 hours. Medication may be constantly administered for 2-3 days by a small plastic tube (nerve catheter) implanted adjacent to the nerve.
How is the block done?
The nerve block is performed mostly under ultrasound guidance, and that is the most advanced approach. The doctor can watch the needle orientation and local anesthetic administration in “real-time” using this approach.
How long does the block take?
A single nerve block usually takes 5-10 minutes to complete. It takes another 15 to 20 minutes to resume normal activities. Before you enter the operation room, the doctors always double-check that the block is functional. When doctors conduct the block, you will be given some sedative drugs to help you relax.
Can we refuse the nerve block?
Yes. You can only be informed of your choices. If the doctors believe that surgery with a nerve block gives the optimum anesthetic conditions with the fewest adverse effects, they will recommend it. In very rare circumstances, general anesthesia may provide a greater risk than surgery through a nerve block. In these circumstances, we highly suggest that you get a nerve block prior to surgery.
Conclusion: Towards a life with less pain
A successful nerve block may assist you in moving toward a pain-free existence. Your pain specialist may start using additional pain-relieving methods like radiofrequency ablation (nerve burning) with this therapy choice for greater long-term comfort.