What is a peripheral nerve injection?

With chronic pain, it can sometimes be difficult to know exactly what’s causing your pain, why you have it, and how to treat it. There are many, many possibilities, and often we start with one treatment plan and then move on to another. 

When we can get a definite, concrete answer to what is causing your pain, it’s a huge victory. Peripheral nerve injections can provide us with this information for some patients. 

What is a peripheral nerve injection?

A peripheral nerve injection is a diagnostic test that helps us determine if a specific peripheral nerve is the source of your pain. We call this procedure a peripheral nerve root block (PNRB). If it is successful in reducing your pain and improving symptoms, then we can identify the exact nerve that is the pain source.

Diagnostic peripheral nerve injections give us a concrete answer to what is causing your pain. With this knowledge, we can come up with and implement an appropriate and effective treatment plan.

But peripheral nerve injections go beyond being just a diagnostic tool. Most patients directly benefit from the procedure. We inject a local anesthetic and steroid that should decrease pain allowing you to complete daily activities much more easily. This may also provide the opportunity for physical therapy and light exercise to strengthen the back and other muscles.

What happens during a peripheral nerve injection?

We typically place a small IV in your hand or arm to provide pain and anxiety relief. We clean the skin at the injection site, and then inject a local anesthetic. This may cause you to feel a slight stinging or burning sensation. Your doctor will then use X-ray guidance to accurately place the needle into the nerve, and then he or she will inject a combined anesthetic and steroid medication.

Immediately after your peripheral nerve injection, we will instruct you to remain in a lying position. After about 30 to 60 minutes, we will check your blood pressure and allow you to try some light activity. At this point, you may experience tingling, tenderness, or itchiness at the injection site. Serious reactions and infections are rare.

After a peripheral nerve injection

In the days right after your injection, your pain may worsen to some extent. Don’t worry — this is normal. The local anesthetic will wear off and the injected medication will kick in about five days post-procedure. If you experience no pain reduction in the following weeks, your doctor will be able to conclude that the specific peripheral nerve targeted was not the pain source. At that point, we will discuss further options for testing and treatment.

We always hope that peripheral nerve injections are successful. It’s a big win if we can pinpoint the exact part of your body causing you pain and then treat it definitively. We will work with you on a very individualized basis to determine if this is the right diagnostic tool and potential treatment option.