Pain Management
Peripheral Nerve Blocks
Targeted Pain Relief Beyond the Spine
While many pain procedures focus on the spine itself, some patients suffer from pain originating in peripheral nerves—the nerves outside the spinal canal that travel into the arms, legs, and other parts of the body. A peripheral nerve block (PNB) delivers anesthetic and sometimes steroids directly around these nerves to relieve pain, reduce inflammation, and confirm diagnosis. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS offers peripheral nerve blocks using advanced imaging guidance, giving patients precise, effective, and minimally invasive relief.
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What Is a Peripheral Nerve Block?
In simple terms: It’s an injection that numbs or calms irritated nerves outside the spine to relieve pain.
Scientifically: PNB involves perineural injection of local anesthetic ± corticosteroid under ultrasound or fluoroscopic guidance, interrupting nociceptive conduction in peripheral nerves.
Conditions Treated
Entrapment neuropathies (e.g., ulnar nerve, carpal tunnel, peroneal nerve entrapment)
Peripheral nerve injuries with ongoing pain
Radiculopathy symptoms extending into arms or legs
Post-surgical or post-traumatic nerve pain
Chronic pain syndromes
Complex regional pain syndrome (CRPS)
The Peripheral Nerve Block Procedure: Step by Step
Plain-English Overview
Preparation: Outpatient procedure; local anesthesia with mild sedation.
Imaging guidance: Ultrasound or X-ray ensures precise targeting of the nerve.
Injection: Local anesthetic ± steroid injected around the nerve.
Observation: Patient monitored briefly; home same day.
Surgeon-Level Detail
Localization: Ultrasound identifies nerve, adjacent vessels, and fascial planes.
Needle technique: 22–25G needle advanced percutaneously under imaging.
Test injection: Small amount of anesthetic confirms placement.
Therapeutic injection: Corticosteroid ± anesthetic injected in perineural sheath.
Closure: Needle withdrawn; sterile dressing applied.
Benefits of Peripheral Nerve Blocks
Rapid pain relief in targeted area
Minimally invasive, outpatient procedure
Diagnostic value to confirm pain origin
May delay or reduce need for surgery
Can be repeated if symptoms recur
Risks & Limitations
Temporary numbness or weakness in injected area
Infection, bleeding, or nerve irritation (rare)
Relief is temporary—hours to weeks—unless paired with other therapies
Not a cure for severe structural nerve damage
Recovery Timeline
Day 0: Mild soreness; numbness may occur in treated area
Days 1–2: Pain relief typically noticeable
Weeks 1–2: Improved function and reduced discomfort
Months: Relief may last weeks to months; repeat injections possible
Why Choose Desert Spine and Pain?
Neurosurgical expertise: Dr. Greenwald specializes in both spinal and peripheral nerve procedures
Advanced imaging: Ultrasound and fluoroscopy ensure precise, safe targeting
Comprehensive care: Peripheral blocks integrated into a larger pain management plan
Patient-centered approach: We focus on reassurance, clear communication, and compassionate care
Frequently Asked Questions
How long do peripheral nerve blocks last?
Relief varies—may last hours to weeks. Blocks are often diagnostic, guiding further care.
Will a nerve block cure my condition?
No, but it relieves pain and helps identify the true pain source. Some patients proceed to longer-lasting treatments like RFA or surgery.
Are nerve blocks safe?
Yes. Risks are minimal when performed with imaging guidance.
What’s the difference between spinal injections and peripheral nerve blocks?
Spinal injections target nerves inside the spinal canal; peripheral blocks target nerves outside the spine in the limbs or body.
How does Desert Spine and Pain perform these differently?
We combine ultrasound and fluoroscopic guidance with neurosurgical precision, ensuring safety and optimal outcomes.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If you’re struggling with persistent pain that hasn’t responded to other treatments, peripheral nerve blocks may offer the targeted relief you need. Dr. Greenwald and his compassionate team will assess your condition, explain your options, and determine whether a nerve block could be part of your personalized pain management plan. Every step you take toward addressing your pain brings you closer to comfort and recovery. Schedule your consultation today and let Dr. Greenwald help you move forward with less pain and greater ease.
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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.
Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon with extensive experience in performing peripheral nerve blocks to help diagnose and relieve chronic pain caused by nerve irritation or inflammation. This minimally invasive procedure involves injecting a small amount of anesthetic, and sometimes steroid medication, near a specific nerve or group of nerves to temporarily interrupt pain signals. Peripheral nerve blocks can be used to manage pain from spinal disorders, nerve injuries, or post-surgical discomfort. Dr. Greenwald uses image-guided precision to ensure accurate placement and effective relief, allowing patients throughout South Florida to experience reduced pain, improved mobility, and enhanced quality of life—often as part of a comprehensive, multidisciplinary treatment plan.
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