What a nerve block is
A nerve block is an injection of local anesthetic, sometimes with a small dose of steroid, placed next to a specific nerve. The anesthetic interrupts the pain signal that nerve is carrying. If the pain drops sharply while the block is working, that confirms the nerve is the source. When a block is repeated, the relief often outlasts the anesthetic, sometimes by weeks or months, because a nerve that has been firing constantly gets the chance to settle.
The blocks we perform are peripheral blocks, meaning they target nerves outside the spine. They are done in the exam room using anatomical landmarks or ultrasound guidance, with no fluoroscopy (X-ray guidance), no sedation and no hospital visit. Spinal procedures such as epidural steroid injections are not done in our offices; when one is needed we coordinate a referral and keep managing your care.
- Occipital nerve block for headaches that start at the back of the head and travel forward, and for occipital neuralgia, the sharp, shooting scalp pain that follows the occipital nerves. Dr. Scheim uses these alongside headache treatment and Botox for chronic migraine.
- Genicular nerve block for knee pain, usually from osteoarthritis, in patients who are not ready for surgery or want to avoid it.
- Suprascapular nerve block for shoulder pain from arthritis, a rotator cuff problem or a frozen shoulder.
- Other peripheral blocks, around the hip, elbow or ankle when the exam points to a single nerve.
How our physicians use them
- Diagnostic block first. The first block is a test. You rate your pain before the injection and again right after it, while the anesthetic is working, and the doctor documents the change. A clear drop confirms the target.
- Therapeutic blocks next. If the diagnostic block helped, the doctor may repeat it, often with steroid, to extend the relief. Blocks at the same site are limited to about three in six months.
- If it does not last. If a block does not give lasting relief, the doctor documents an alternative plan: a different treatment, a referral, or a change in medication. Blocks are not repeated indefinitely.
- Alongside other care. Blocks are combined with trigger point and joint injections, physical therapy guidance and, at Davie, StemWave shockwave therapy.
Does insurance cover it? Nerve blocks are covered by Aetna, Blue Cross Blue Shield, Cigna and other in-network plans and Medicare Advantage when medically necessary, and prior authorization is often required first. We want to be straightforward about Medicare: its coverage rules for nerve blocks used for chronic pain are under review, and the position can differ by type of block and diagnosis. For that reason our front desk confirms your coverage with your plan before any block is scheduled, so there are no surprises. Read more about insurance and self-pay.
What to expect
- Before you come in, we verify coverage and any authorization, and ask for photo ID, your medication list and prior imaging. Tell us about blood thinners or a recent infection.
- At the consultation, the doctor examines you, traces the pain to a nerve and explains whether a block is likely to help.
- The block takes about 10 to 15 minutes. The skin is cleaned and numbed, the doctor locates the nerve by landmark or ultrasound, and the medicine is injected. You feel pressure and, briefly, a deep ache.
- Right after, you wait 15 to 30 minutes, rate your pain again and the result is recorded. Numbness in the area is normal for a few hours. Most patients drive themselves home.
- Follow-up in two to four weeks decides whether to repeat the block, move to a therapeutic series or change course.
| What it treats | Occipital headaches and neuralgia, knee osteoarthritis pain, shoulder pain, other single-nerve pain |
|---|---|
| Visit length | About 45 minutes including the wait to record your response |
| Typical course | One diagnostic block, then therapeutic blocks as needed, up to about three per site in six months |
| Downtime | None; numbness for a few hours, then take it easy for the rest of the day |
| Coverage | Covered when medically necessary; prior authorization often required; Medicare confirmed case by case |
Safety
Peripheral nerve blocks have a low complication rate. Bruising, temporary soreness and a short-lived increase in pain are the most common effects, and steroid can raise blood sugar for a few days in people with diabetes. A block is postponed if there is an infection near the site or an unmanaged bleeding risk.
Do I need to stop blood thinners before a nerve block?
Sometimes, and never on your own. Tell the front desk what you take when you book, and the doctor decides whether the block can go ahead safely or a short pause is needed.
How long does the relief last?
A diagnostic block wears off in hours; that is its purpose. Therapeutic blocks often give weeks to a few months of relief, and repeated blocks can extend that. Results vary, which is why the response to every block is written down.
Is a nerve block the same as an epidural injection?
No. An epidural is a spinal injection done under X-ray guidance in a procedure suite, which we do not perform in the office. If you need one, we coordinate a referral and keep managing your care.
Which clinic offers nerve blocks?
Both. Peripheral nerve blocks are performed at Davie for Broward County and at Boynton Beach for Palm Beach County.
Will Medicare cover my nerve block?
It depends on the block and the diagnosis, and Medicare's rules for chronic pain blocks are under review. The front desk checks your specific coverage before anything is scheduled. Self-pay is available if a block is not covered.