An ultrasound-guided injection placed around a specific peripheral nerve — used both to identify the source of your pain and to provide targeted relief.
A peripheral nerve block is an injection of local anesthetic — sometimes with a small amount of corticosteroid added — placed precisely around a specific peripheral nerve, well away from the spinal cord. We use real-time ultrasound to see the nerve, the surrounding vessels and tissue planes, and the needle itself, which allows the medication to be deposited exactly where it belongs and not where it doesn't.
Peripheral nerve blocks serve two related purposes. The first is diagnostic: if numbing a specific nerve clearly relieves your pain, that's strong evidence the nerve is the source — and it opens up longer-acting options like pulsed radiofrequency, cryoneurolysis, or peripheral nerve stimulation. The second is therapeutic: the anesthetic plus steroid effect can quiet an irritated or entrapped nerve for weeks to months, sometimes longer.
Peripheral nerve blocks are most useful when the history and exam point to a specific nerve as the pain generator. Common targets we treat include:
A peripheral nerve block is generally not the right choice when the pain pattern doesn't fit a specific nerve, when there's a local infection at the site, when an uncontrolled bleeding disorder hasn't been managed, or when the underlying problem is better addressed at a different level — for example, when a clearly radicular pain from a pinched nerve in the spine would be better served by an epidural injection.
You'll be positioned to give us clear access to the target nerve — seated, side-lying, or face-down depending on the nerve. The skin is cleaned with antiseptic and a sterile drape is placed.
We scan first to identify the nerve and surrounding structures — vessels, muscles, fascial planes — and to choose the safest needle path.
The skin is numbed, then a thin needle is guided in real time to the nerve. Once placement is confirmed, anesthetic — and sometimes a small dose of steroid — is delivered around the nerve.
You rest for 15–20 minutes while we confirm the effect and that you feel well. Total visit time is usually 20 to 30 minutes.
Recovery depends on which nerve was treated. For most of the blocks we perform — occipital, suprascapular, genicular — there is no functional limitation afterward and you can return to normal activity the same day. For blocks involving nerves that supply major muscle groups in the limbs, the local anesthetic can produce temporary numbness and mild weakness lasting several hours; in those cases we'll give you specific safety instructions — don't drive, avoid stairs, plan for someone to help you home — until the block fully wears off.
We'll often ask you to keep a brief pain diary in the days after the block. The anesthetic phase is diagnostically important — clear relief during the first few hours tells us the nerve is the culprit and helps us plan the next step, whether that's a repeat block, a longer-acting neuromodulation procedure, or a different approach entirely.
Peripheral nerve blocks are very safe when performed under real-time ultrasound. The most common issues are bruising and soreness for a day or two. Temporary numbness or weakness in the muscles supplied by the nerve resolves as the anesthetic wears off. Infection is rare with sterile technique. Direct nerve injury is very uncommon and is further minimized by ultrasound visualization, which lets us see the needle tip throughout the procedure. Steroid-related effects — a brief rise in blood sugar for diabetics, facial flushing, a few nights of disrupted sleep — are possible when steroid is included. Tell us about any allergies to local anesthetic and about blood thinners in advance.
KeyTone Medical is out of network with all commercial health insurance plans, so this procedure is self-pay, with the cost discussed before anything is scheduled. Many plans reimburse part of the cost of medically necessary care performed out of network — on request we provide a superbill, an itemized and coded receipt, for you to submit to your insurer under your plan's guidelines.
A spinal injection — like an epidural or a facet injection — is performed at the level of the spinal column itself. A peripheral nerve block is performed farther downstream, where the nerve is in your shoulder, knee, head, pelvis, or limb. The two address different problems: spinal injections target irritation at the spinal nerve root, while peripheral nerve blocks target the nerve in its course after it has left the spine.
For most of the blocks we perform — occipital, suprascapular, genicular, ilioinguinal — yes. For blocks that may temporarily weaken a major muscle group in the limb, you'll need someone to drive you home and we'll give you specific instructions about activity until the block wears off. We'll always tell you in advance which category applies to your procedure.
It varies. The immediate anesthetic effect lasts a few hours. When steroid is added and the block is therapeutic, relief can last weeks to a few months. When the block is primarily diagnostic, the value is less in the duration of relief and more in the information it gives us about whether this nerve is the right target for a longer-lasting treatment.
A clearly positive block is good news — it tells us we've located the right nerve. From there, options often include a repeat block, pulsed radiofrequency, cryoneurolysis, or peripheral nerve stimulation, depending on the nerve and your situation. We'll lay out the choices honestly so you can decide what fits.
There's a brief sting when we numb the skin and some pressure as the needle is advanced. Most patients tolerate it well without sedation. Because we use ultrasound, the needle path is direct and we don't have to "fish" for the nerve — that tends to make it more comfortable than older, blind techniques.
Authoritative references on this topic, for patients who want to read further. These are educational resources, not medical advice.
Educational information only. This page describes peripheral nerve blocks in general terms. Whether one is appropriate for you depends on your history, exam, imaging, and the specific nerve in question. The risks, benefits, alternatives, and expected results will be discussed in detail at your visit.
