Dr Samuel Bolitho

Nerve Blocks

Nerve blocks are a procedure used in neurology and pain management, involving the injection of medication directly into specific nerves, or around them, to alleviate pain. They can be diagnostic, therapeutic, or both.

The procedure is performed using local anaesthetic, often combined with a corticosteroid. There are several types of nerve blocks, including peripheral nerve blocks, sympathetic nerve blocks, and spinal blocks (epidural and spinal anaesthesia).

Mechanism of Action

  1. Inflammation Reduction: When corticosteroids are used, they can reduce inflammation and swelling around the nerve.
  2. Pain Relief: The injected substances block pain signals from being sent to the brain.

Conditions Treated

  • Neuropathic Pain: Such as in diabetic neuropathy or postherpetic neuralgia.
  • Complex Regional Pain Syndrome (CRPS): A chronic pain condition affecting an arm or a leg.
  • Surgical Pain: Postoperative pain management.
  • Trauma: Pain resulting from injuries.
  • Migraines and Cluster Headaches: Occipital nerve blocks can be effective.
  • Trigeminal Neuralgia: A chronic pain condition affecting the trigeminal nerve in the face.
  • Herniated Discs: Epidural injections can reduce inflammation around the nerves.
  • Spinal Stenosis: Nerve blocks can alleviate pain caused by narrowing of the spaces within the spine.
Rheumatoid Arthritis and Osteoarthritis: Particularly in the spine or large joints.
For pain management in advanced cancer cases affecting nerves.

The Procedure

  1. Preparation: Involves a physical examination and review of medical history.
  2. Guidance Techniques: Fluoroscopy or ultrasound may be used for precise placement of the needle.
  3. Duration: The actual injection takes only a few minutes, but the overall procedure may take longer due to preparation and recovery.

Risks and Side Effects

  • Infection and Bleeding: At the injection site.
  • Nerve Damage: Rare but possible.
  • Allergic Reactions: To the anaesthetic or steroid.
  • Temporary Weakness or Numbness: In the area served by the nerve.
  • Radiation: Fluoroscopy is a form of x-ray that involves low-dose radiation. Ultrasound does not involve radiation.


  • Targeted Relief: Provides significant pain relief in the specific area.
  • Reduced Dependence on Oral Medications: Can decrease the need for oral painkillers.
  • Diagnostic Tool: Helps in pinpointing the source of pain.

Limitations and Considerations

  • Temporary Relief: Effects can vary in duration and are not permanent.
  • Frequency of Treatments: Repeated blocks may be necessary.
  • Not a Cure: Addresses symptoms but not the underlying cause of pain.

Nerve blocks in neurology are a valuable tool for managing various types of pain, especially when other treatments have failed. They offer targeted pain relief with minimal systemic side effects. However, they are generally part of a broader pain management or treatment strategy, and their effectiveness can vary from person to person.

If a Nerve Block is a treatment modality you would like to learn more about, please contact our rooms to make a booking.

Get In Touch

Dr Samuel Bolitho is a Sydney Neurologist with sub-specialised training in movement disorders, essential tremor and Parkinson’s Disease. He brings a rare mx of medical, neurological and computational neuroscience expertise to his role, as well as a wealth of experience in biomedical engineering.