Blockades
In medicine, by blockades they mean the injection of an analgesic and / or anti-inflammatory drug in the area of the pain source or peripheral nerve. The blockade reduces inflammation at the injection site, reduces pain and relieves reflex muscle spasm. Blockades are widely used in the treatment of acute and chronic pain. Correct and timely blockade significantly reduces the level of pain and the need for painkillers, significantly reduces the risk of acute pain conversion to chronic one.
Types of blockades.
1. Central neuraxial blockade - The drug is injected into an area directly adjacent to the central nervous system. This group includes epidural blocks, nerve root blocks, and spinal analgesia, which are widely used in surgery, for pain relief in labor, and in the treatment of acute and chronic pain syndromes. In algology, these blocks are used to manage radicular pain caused by nerve compression, as well as chronic pain resulting from narrowing (stenosis) of the spinal canal. This type of blockade is recommended to be done under X-ray or ultrasound navigation. Performing these blockades without imaging control, blindly, cannot guarantee the accuracy of procedure and bears high risk of serious complications, especially in the cervical and thoracic spine.
2. Blockade of peripheral nerves.
In these cases, the drug is injected into the tissue immediately adjacent to the nerve. Peripheral nerve blockade is widely used in conditions associated with compression of the nerves by the surrounding tissues. E. g., median nerve blocks in carpal tunnel syndrome, occipital nerve blocks in occipital neuralgia. Doctors usually use ultrasound navigation to deliver medication as accurately as possible. The use of ultrasound navigation significantly reduces the likelihood of nerve and vascular damage.
3. Infiltration blockade.
Medication is injected directly to the source of inflammation and pain. E. g., blockade of trigger points in myofascial pain syndrome, local blockade in the cavity of the bursal sac (subacromial bursitis), blockade in the tendon area (tennis elbow). These types of blockades effectively relieve inflammation and pain, increase the range of motion in the affected area, significantly shorten the recovery period.
4. Intra-articular blockade.
Drugs are injected into the joint cavity. The main indications for intra-articular blockades are chronic diseases causing degeneration in the tissues of the joints - arthrosis. In addition to painkillers and anti-inflammatory drugs, hyaluronic acid preparations are often injected into the cavities of large joints. These medications compensate for the deficiency of intra-articular fluid, improve the sliding of the articular surfaces of the bones, reduce pain in the joint and slow down the process of destruction of cartilaginous tissue.
5. Diagnostic blockade.
This type of blockade is used to confirm or rule out the diagnosis of a disease. For the purpose of diagnostics, the drug is injected into the area of the alleged source of pain. A significant decrease (or complete disappearance) of pain allows you to confirm the correctness of the preliminary diagnosis. It allows for making a treatment plan that is adequate for the disease. An example is blockade of the nerves that innervate the intervertebral joints.
6. Contraindications to blockades:
Septic conditions.
Intolerance to the drugs used for the block.
Blood clotting disorders.
Infection in the site of blockade.
Severe mental disorders.
Severe heart or pulmonary failure.
7. Possible complications:
Allergic reaction.
Damage to blood vessels, nerves.
Bleeding.
Infectious complications.
Inadvertent injection of drugs into blood vessels.
In order to reduce the number of possible adverse events and side effects caused by blockades, it is strongly recommended to use modern imaging tools, like ultrasound navigation or X-ray control, which allows the blockade to be performed as efficiently as possible and with minimal risk of complications.
Types of blockades.
1. Central neuraxial blockade - The drug is injected into an area directly adjacent to the central nervous system. This group includes epidural blocks, nerve root blocks, and spinal analgesia, which are widely used in surgery, for pain relief in labor, and in the treatment of acute and chronic pain syndromes. In algology, these blocks are used to manage radicular pain caused by nerve compression, as well as chronic pain resulting from narrowing (stenosis) of the spinal canal. This type of blockade is recommended to be done under X-ray or ultrasound navigation. Performing these blockades without imaging control, blindly, cannot guarantee the accuracy of procedure and bears high risk of serious complications, especially in the cervical and thoracic spine.
2. Blockade of peripheral nerves.
In these cases, the drug is injected into the tissue immediately adjacent to the nerve. Peripheral nerve blockade is widely used in conditions associated with compression of the nerves by the surrounding tissues. E. g., median nerve blocks in carpal tunnel syndrome, occipital nerve blocks in occipital neuralgia. Doctors usually use ultrasound navigation to deliver medication as accurately as possible. The use of ultrasound navigation significantly reduces the likelihood of nerve and vascular damage.
3. Infiltration blockade.
Medication is injected directly to the source of inflammation and pain. E. g., blockade of trigger points in myofascial pain syndrome, local blockade in the cavity of the bursal sac (subacromial bursitis), blockade in the tendon area (tennis elbow). These types of blockades effectively relieve inflammation and pain, increase the range of motion in the affected area, significantly shorten the recovery period.
4. Intra-articular blockade.
Drugs are injected into the joint cavity. The main indications for intra-articular blockades are chronic diseases causing degeneration in the tissues of the joints - arthrosis. In addition to painkillers and anti-inflammatory drugs, hyaluronic acid preparations are often injected into the cavities of large joints. These medications compensate for the deficiency of intra-articular fluid, improve the sliding of the articular surfaces of the bones, reduce pain in the joint and slow down the process of destruction of cartilaginous tissue.
5. Diagnostic blockade.
This type of blockade is used to confirm or rule out the diagnosis of a disease. For the purpose of diagnostics, the drug is injected into the area of the alleged source of pain. A significant decrease (or complete disappearance) of pain allows you to confirm the correctness of the preliminary diagnosis. It allows for making a treatment plan that is adequate for the disease. An example is blockade of the nerves that innervate the intervertebral joints.
6. Contraindications to blockades:
Septic conditions.
Intolerance to the drugs used for the block.
Blood clotting disorders.
Infection in the site of blockade.
Severe mental disorders.
Severe heart or pulmonary failure.
7. Possible complications:
Allergic reaction.
Damage to blood vessels, nerves.
Bleeding.
Infectious complications.
Inadvertent injection of drugs into blood vessels.
In order to reduce the number of possible adverse events and side effects caused by blockades, it is strongly recommended to use modern imaging tools, like ultrasound navigation or X-ray control, which allows the blockade to be performed as efficiently as possible and with minimal risk of complications.