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Peripheral Nerve Blocks and Stimulators

A peripheral nerve is a nerve outside of your spinal cord that can not only control muscle movement of your body, but can also carry pain signals back to your brain. With a peripheral nerve block or stimulator, we can target these pain sensory nerve fibers and block pain signals from reaching your brain and give you significant pain relief.

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Peripheral Nerve Blocks and Stimulators Q&A

Q: What medications will be used?

Dr. Zhang will tailor the best and safest formulation and dose for every single patient individually to help ensure maximum results. For a peripheral nerve block, the injectate will typically depend on the exact location, injection approach, type of medication(s), dosage of medication(s) that best fit your specific pain. Typically a local anesthetic will be used. A local anesthetic is a medication that is often used as a numbing agent by blocking pain signals. Sometimes a steroid can also be added if the cause of your pain is inflammation. Steroid is a medication that can be used to treat many painful conditions by decreasing inflammation.

For a peripheral nerve stimulator, typically only a local anesthetic medication will be used to help ensure your comfort during the stimulator placement. Once the stimulator is in place, it will continue to work to decrease your pain afterwards.

Q: What is the peripheral nerve injection procedure like?

For a peripheral nerve injection, our staff will help position you appropriately. Depending on the location of the nerve being injected, we may have you sitting up, laying down on your back, or even laying down on your stomach. We will clean off your skin with some cold soap, which is very important to prevent infection. You will receive some numbing medication that will help prevent pain with the procedure. The doctor will then use ultrasound to guide a needle into place. Once confirmed, the medication will be slowly injected. We will then monitor you and go over discharge instructions before letting you leave.

Q: What is the peripheral nerve stimulator procedure like?

For a peripheral nerve stimulator, the process may be different depending if you have a temporary stimulator or a permanent stimulator placed. For a temporary peripheral nerve stimulator, the procedure will be done under ultrasound guidance. After some local anesthetic (numbing agent) is injected for your comfort, a small wire can be placed. This stimulator may remain in place up to 60 days. When the stimulator is activated, you may feel some pleasant tingling sensations, called paresthesias, that may replace your pain - don’t worry, this is normal! During these 60 days, it will work to decrease pain and may even help reset your nerve signaling to provide pain relief even after it’s removal. We will give you specific discharge instructions and teach you how to take care of your device and change dressings at home. At 60 days, the wire can be simply removed in the office.

For a permanent peripheral nerve stimulator, you will first need to undergo a trial period of 5-7 days with temporary leads, meaning this stage is completely reversible! These temporary leads will be placed under ultrasound guidance, exactly like how the permanent leads will be placed. After confirming their exact location, will then monitor you and go over discharge instructions before letting you leave. Once your device is activated, you may feel some pleasant tingling sensations, called paresthesias, replace your pain- don’t worry, as this is perfectly normal! We will monitor you and give you careful discharge instructions before you leave. Someone from our office and/or your medical device company representative will be in touch with you daily to track your progress in terms of pain and activities of daily living.  At the end of your 5-7 day trial period, we will remove your leads in our offices. Don’t worry, this step does not hurt, and often patients complain more about the tape removal than the leads! Once you have undergone a successful trial period, then we will move forward with the device implant at that point of time.

Q: Am I allowed to go back to work on the same day?

Yes, we do allow patients to go back to work after a peripheral nerve block. However, we do caution against any heavy lifting or vigorous activity. But we do encourage you to try some of the activities that initially bothered you, as this may help with your diagnosis.

For a peripheral nerve stimulator, we may give you more specific discharge instructions. During the entire temporary trial period and the beginning after a permanent implant, please be aware that you will have certain restrictions like no vigorous activity (running, jumping, etc.) and no contact with water (bath, shower, pools, etc.). However, we do encourage you to try some of the activities you normally have trouble performing as this may be an indicator of your functional improvement.

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