Anesthetic:  Local

Pain typically comes from nerves that become irritated from some type of insult whether it be from surgery or any type of trauma.  By placing a local anesthetic with a small dose of steroid, which is a strong Anti-inflammatory, on the nerve that is irritated, this can decrease the swelling around this nerve which decreases your pain.  This procedure targets a specific nerve that may be causing your pain which has the potential of not only giving you pain relief but also determining a specific diagnosis for your pain.  Some common indications and nerve disorders that can benefit from this includes:

  • Chronic Headaches
  • Occipital neuralgia
  • Trigeminal neuralgia
  • Facial pains
  • Neck and shoulder pain
  • Chest pain from intercostal neuralgia
  • Postthoracotomy pain syndrome
  • Chronic abdominal pain after surgery
  • Pain after hernia surgery
  • Chronic leg pain after any type of trauma
  • Any type of specific nerve pain

Contraindications/Reasons why you may not have your injection today:

  • Bleeding disorders/low platelet counts
  • Medications that thin your blood (please review this section)
  • Current infection
  • No driver
  • Your symptoms have changed and/or improved
  • Patient refusal
  • Procedure not approved by your insurance
  • Poorly controlled high blood pressure that may be giving you symptoms
  • Poorly controlled diabetes
  • Certain types of glaucoma
  • Poorly controlled bipolar disorder
  • Allergies to the any of the medications that is being used

Potential side effects/risks of the procedure:

  • Increased pain
  • Numbness in lower extremities that is short lived
  • Infection
  • Bleeding
  • Allergic reaction
  • Cramping in lower extremities
  • Mood changes
  • Flushed face/extremities
  • Headaches
  • Worsening of high blood pressure
  • Increasing of blood sugars if you have diabetes
  • Water retention
  • Chronic steroids can cause weight gain
  • Seizures
  • Stroke
  • Nerve injury

During the procedure, you will be in the best position to be able to safely and most comfortably perform the injection.  After the area on your skin is marked, your skin is cleaned with an antiseptic solution, typically betadine unless you are allergic.  The skin may be localized with a local anesthetic which is typically the most painful part of the procedure as this medicine has a tendency to burn when it is injected.  After this point, you should only feel pressure.  If anything is too painful for you, please tell your provider as more numbing medicine can be given at any time.  When the needle is on the nerve, a solution containing both a local anesthetic and steroid is slowly injected. You may experience increased pain/pressure in that specific area which is to be expected.  However, if at any time the pain is too intense, please tell your physician to slow down your injection.  After the medication is injected, the needle is removed and the procedure is completed.

Typical length of the procedure: 
5 minutes.  Expect to be at the clinic no more than 15 minutes after you have been checked in by the medical assistant into the preoperative area.  If this is your first time at our clinic, you will likely be at the clinic for at least one hour.  Please plan accordingly.

How long do you expect pain relief: 
It is difficult to determine how long and how much pain relief you may experience.  It varies depending on multiple factors.  Some patients do not gain any relief from the procedure and some may have permanent relief.  If you experience relief right after this procedure, this can be diagnostic that your pain is coming from the specific nerve(s) that was injected today.


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