Nerve Block?
 

Has anyone every had much relief from a nerve block? My pain and rehabilitation doctor wants to do it but I am not so sure. The coritzone shot did not work....

Thanks in advance for replies :)

Most nerve blocks contain lidocaine -- which is a local anesthetic.

Most of the patients here who get them, are on our RSD board, and won't be reading this question here.

Did you use your Lidoderms on the spine in the affected area?
That would be a hint as to whether an injection would work.

Some patients like these and others don't. I don't think enough MP patients come here to give you a good sampling of this treatment.

You might want to read my magnet thread. Really strong magnets can block pain signals..I use them myself, but not for MP, but for other types of pain.

http://neurotalk.psychcentral.com/sh...hlight=magnets

The really high gauss magnets available today can be very effective.

Skully, those blocks can be effective in certain patients with MP. I think it is more effective in those with a "constricture" around the nerve and the local is merely a means of releasing the nerve

meralgia paresthetica treatment
 

Skully,

I recently read your post regarding a nerve block for meralgia paresthetica. I am a Harvard-trained plastic and peripheral nerve surgeon and also use nerve blocks to help in the diagnosis of this condition. However, in my hands, the nerve block is as diagnostic test, not a treatment modality. In other words, if the physical exam suggests MP and there is a positive Tinel sign on physical exam, that to me is a sign of peripheral nerve compression (just like carpal tunnel syndrome). If the patient responds positively to a nerve block they are a candidate for a decompression procedure to hopefully give them more permanent relief. This procedure is done as an outpatient and often takes less than two hours. As you know, meralgia paresthetica (compression of the lateral femoral or lateral femoral cutaneous nerves is a condition which results in a lot of anterior and lateral thigh (sometimes buttock) pain. Most people do no know this it can be very successfully treated with decompression surgery. It is a procedure I have performed on more than one occasion. In fact, I presented my results with this very procedure at the California Society of Plastic Surgeons Meeting last May. In that series of patients, the pre-operative pain intensity score was 9.4/10 and post-op was only 1/10.

I got a nerve block two weeks ago. This must be done by an experienced anesthesist. The anesthesist looks via ultrasound where your nerve exits your abdomen and then injects lidocain exaclty at this point. Only if the doctors hits the exact place a nerve block can be effective. I got several nerve blocks by unexperienced doctors which didn't give me any relieve.
The nerve block from the anesthesist was great. I had no pain for about 24 hours. I've heard that if you repeat the nerve block 3-5 times your pain can disappear for more month or forever. But its difficult to find a doctor who is willing to do the block more than one time...

nerve blocks
 

Dear Penny22,

Nerve blocks are meant to be diagnostic tests, not treatment modalities. In other words, they function like, for example, an MRI. If an MRI is performed to see if someone has a tumor and the MRI shows that they do, this result and knowledge has not fixed the problem, only provided more information to the treating physician who can then decide how to manage the patient accordingly. Similarly a nerve block will demonstrate several things. For example, when a particular nerve is blocked and the pain goes away,it can suggest that the nerve which was blocked is the source of pain. It MAY also suggest that the nerve in question is injured at the site of the block itself. Sometimes, the local anesthetic (which will only last a few hours at the most as in your case) in a nerve block is also combined with a steroid medication (i.e. an anti-inflammatory) to try and reduce any inflammation of the nerve. While this addition may be helpful in improving symptoms, it is often ineffective and at best temporary. While it may last a few weeks or even months, the symptoms eventually return. On rare occasions, the results may be permanent, but physicians do not know why this occurs as there is no physiological explanation for how that would occur. In addition, inappropriately placed steroid injections can cause a lot of damage if they are injected into the nerve itself or too superficially in the skin.

In the case of meralgia paresthetica, there are numerous studies which demonstrate that the nerve in question is compressed physically. This compression can be because of a tight canal through which the nerve is passing, a swollen nerve or some combination of both. I don't know if it is possible on this forum, but if so, I could show you examples of nerves in patients with MP which are compressed at the beginning of the case and decompressed at the end. No amount of local or steroid will achieve that result. Secondly, surgery is the only way I know of to remove the physical compression safely and permanently because you can actually see and protect the nerve you are releasing in order to do so safely. Hope this information is helpful.

Drp.

Dear Drp.
Thank you for the valuable info.
Actually This is my fourth week with MP which I got because of bilaterlal laparoscopic hernia repair with mesh and absorbable staples.
While my neurologist says the pain may go by itself, I've read an article that advises to do a nerve decompression surgery as soon as possible and favorably no more than 12 weeks after the abdominal surgery to increase the chances of success of the decompression operation and avoid permanent nerve damage.

I am currently trying to know which surgeon specialty is best qualified to do such operations, is it neuro surgeons or plastic surgeons?
I also think that my condition is much better than when I woke up from my surgery but I am still feeling the burning and getting the acute pain when I move my leg in certain positions so should I wait or not?

Your help is much appreciated.

relief
 

The nerve block was used to diagnos the problem which we already knew what I had. I do not believe it will provide any relief long term.

Hopeless
 

I read an article that talked about a staple being right through the LFCN after placing mesh for a hernia repair. Sounds like this could be your situation. In the article, they went in and removed the staple.