A Painful Problem

Pain is a common symptom of inflammation, injury, or disease. When people have an injury, inflammation, or disease, the surrounding nerves send signals to the brain. The brain responds with the feeling of pain in the specific area. Mild pain due to minor injuries and disorders can usually be treated with home remedies and medications. Chronic pain, however, such as pain caused by spinal conditions, can be excruciating and debilitating. In this case, drugs may no longer be enough, and a doctor may recommend nerve blocks or epidural injections to help manage the pain. Both are effective in chronic pain management, but the applications still vary. Comparing the two treatments can help patients make smart decisions.

Getting on my nerve

Nerve blocks are one of the first advanced procedures a spinal surgeon suggests. A local anesthetic provides short-term pain relief by temporarily shutting down the pain receptors on the affected nerves. Nerve blocks typically treat localized nerve pain, such as sciatica, or help determine the exact source of pain. These injections also lessen inflammation and heal some damaged nerves. Doctors administer nerve blocks as an outpatient procedure using imaging guidance such as fluoroscopy, CT scan, or ultrasound. The effect of nerve blocks is immediate lasts for 1-2 weeks. In some cases, nerve blocks are combined with steroids for long-term use.

Filling the space

Epidural injections are also non-surgical treatments for chronic pain, particularly for back conditions like herniated discs or spinal stenosis. Pain medicine and anesthetic are injected into the epidural space, the space between the spinal bones and the spinal cord membrane. Although this treatment only provides short-term relief, the effect lasts longer than nerve blocks. In some cases, epidural injections last 1 month or more. In addition to managing pain, epidural injections can minimize inflammation and swelling. This can allow patients to continue with physical therapy or postpone surgery.

Are these shots the same?

Nerve blocks and epidural injections provide temporary pain relief. Both are minimally invasive and can be administered through an outpatient procedure, lasting roughly 30 minutes. Although low, there are still risks associated with these procedures. These risks include bleeding and infection at the injection site, dizziness, and headache. Patients who receive nerve blocks or epidural injections are advised not to drive or perform strenuous activities for at least 24 hours.

What are the differences?

The effect of epidural injections lasts longer than that of nerve blocks. However, nerve blocks can be used to treat pain in different body parts since the procedure uses an imaging device to precisely position the needle. On the other hand, epidural injections are only for back pain since the pain medicine is directly injected into the epidural area. Nerve blocks are also excellent for diagnosing spinal conditions and other joint issues, allowing doctors to suggest further treatment.

Which should you choose?

Nerve blocks and epidural injections are generally safe and effective to relieve pain. Doctors typically use nerve blocks first, then move to longer-lasting epidurals next, if needed. Patients can also receive multiple nerve blocks or epidurals over time for a prolonged effect. However, both are usually used along with other treatments. Most patients immediately feel the effect, so a surgical procedure is the next best option if the pain is still persistent.