What is a Nerve Block?: Your Guide to Regional Anesthesia

| February 27, 2013 | 101 Comments

If you are scheduled for surgery, you might be surprised when your surgeon or anesthesiologist recommends a nerve block. Here you’ll find out exactly what it is, how it’s done, what the benefits are, and what complications could arise.

Nerve blocks are placed by anesthesiologists  to help minimize or eliminate the pain of surgery. Most often, nerve blocks are performed for orthopedic surgeries and can drastically reduce the amount of discomfort you may have after surgery. This can help speed up the recovery and rehabilitation process.

In most cases, the nerve block is provided in addition to general anesthesia. That way, you can be asleep for your surgery and then wake up with less pain.

For example, for major shoulder surgery, your orthopedic surgeon may feel that a nerve block would be beneficial for you. In the usual scenario, the nerve block is placed prior to general anesthesia. So you would have a shoulder that is essentially numb (and pain free) whenever you wake up from your shoulder surgery.

What is a nerve block?

Simply stated, a nerve block is the placement of local anesthetic (eg. lidocaine) and perhaps some additive medicines onto, or near, a nerve or bundle of nerves. This serves to “numb” the area that nerve supplies, decrease/stop the ability to move, and provide pain relief for surgery in that location.

How it’s Done:

Once you have spoken with everyone involved, including your surgeon and anesthesiologist, and all your questions have been answered and your consent for the “block” obtained,  your nerve block can be placed.

Your anesthesiologist gives you “relaxing medicine” through your IV, places monitors to ensure your safety (eg., blood pressure, EKG, pulse oximetry) and then gets ready to perform the nerve block. There are several techniques to properly locate the nerve(s). The most common in use today include visualization with ultrasound and/or the use of nerve stimulation. Once you are comfortable from the IV medicine, the procedure will begin.

A few moments are spent identifying the correct area of your body where the nerves of interest are located. For the nerves that provide sensation to your shoulder, for example, the nerves are often “blocked” by placing medicine near your neck. For knee surgery, some of the nerves to be blocked are located near your groin.

Once the correct area for the nerve block is identified by the anesthesiologist, numbing medicine is placed into the area. This numbing medicine, or local anesthesia, can last greater than 24 hours in some cases. Alternatively, a nerve block catheter may be placed that will continuously infuse numbing medicine into the extremity for several days of pain relief.

Nerve blocks performed:

We typically perform nerve blocks for surgeries including orthopedic shoulder surgeries of all varieties, carpal tunnel surgery, hand surgery, hip replacements, knee replacements, knee ACL reconstructions, ankle surgeries, and foot surgeries. If you have a fractured extremity, your orthopedic surgeon might ask the anesthesiologist to place a nerve block to help decrease the pain in this extremity as well. Sometimes, nerve blocks can be used as the sole anesthetic for some surgeries, including carpal tunnel surgery and foot surgery. The principle is that if your arm or leg is numb, you don’t experience any pain!

The nerve blocks most commonly used are the interscalene block, supraclavicular block, infraclavicular block, axillary block, lumbar plexus block, femoral block, sciatic block, popliteal block, and ankle block. However, there are other blocks that can be performed depending on your type of surgery.

Benefits of Nerve Blocks:

As mentioned above, the overwhelming benefit is a decrease in post operative pain. This means you will likely need less of the IV pain medicine that has the potential to make you sleepy, nauseated, constipated, or itch. You may be able to participate earlier in physical therapy, and you may even be able to go home quicker (decreasing your chance of a hospital-acquired infection or medical error).

Also, with a nerve block in place, the anesthesiologist will not need to give you as much pain medicine while you are asleep under general anesthesia. This can lead to less post operative nausea and vomiting as well as a quicker recovery from general anesthesia.

Potential Complications of Nerve Blocks:

With any procedure that physicians do, there is always the possibility of complications. Fortunately, the incidence of major complications from nerve blocks is very low. The most common thing I tell patients is that the nerve block might not take away all of the pain after surgery. If this occurs, your nerve block can be supplemented with IV or oral pain medicine.

Also, the nerve block may not work at all. While this is an unlikely scenario, this potential still needs to be discussed. Your anesthesiologist may offer to place the nerve block again after surgery if this occurs.

A feared complication of nerve blocks is the potential for permanent numbness (or any other neurologic symptom) to occur in the extremity. This is very rare. In fact, if numbness in the extremity does continue longer than expected, in the large majority of cases, the numbness will eventually resolve and is not permanent.

Another potential complication is that the local anesthetic might be injected into a blood vessel. This can potentially lead to “local anesthetic toxicity.” This is a serious complication that may cause your heart to stop. And for this reason, anesthesiologists monitor you throughout the placement of the nerve block and immediately afterward to watch for signs of toxicity; ready to give rescue medicine if necessary.

We often use an ultrasound machine to watch where we inject the medicine, and we can see blood vessels with this technology.

Other potential side effects are bleeding and infection. The skin through which the block is placed is cleaned with a sterile solution and sterile gloves are used. Infection is rare. Also, unless a blood vessel is inadvertently pierced, the likelihood of serious bleeding from a nerve block is also rare.

And once again, this is why anesthesiologist monitor you throughout the placement of a nerve block.

Why You Wouldn’t Receive a Nerve Block: Contraindications

The surgeon will guide you and let the anesthesiologist know if a nerve block could be beneficial to you. Then, your anesthesiologist will review your medical history, type of surgery, and speak with you about the block.

After hearing the benefits and risks of a nerve block, it is ultimately up to you to decide whether or not you want this procedure to be performed. I don’t anticipate this happening, but you should never feel pressured to have a nerve block placed for your surgery. The first contraindication to any procedure is patient refusal.

Besides patient refusal, there are some other instances in which a nerve block may not be indicated. Ultimately, this is an individual anesthesiologist’s decision. These situations include active infection or sepsis, bleeding disorders, and peripheral neuropathy (or extremities that are already numb from a chronic medical condition).

Tips for Post-Op Care

Remember that a nerve block will cause part of your leg or arm to be “asleep.” So you will need to be careful with this extremity and make sure you don’t bump into anything. If you have had shoulder surgery, your arm will probably be in a sling. And if you have had hip, knee, ankle, or foot surgery, please use caution when standing up for the first time. You may feel that your nerve block has worn off, but your muscles may still be weak, and you could fall.

Also, your nerve block will eventually wear off. When you start to get the feeling that your block is subsiding, make sure to go ahead and take pain medicine. If you wait until the block completely wears off, and you haven’t taken any pain medicine, you may get behind on pain control.

Parting thoughts:

If you are having extremity surgery, a nerve block may be beneficial to alleviate post operative pain and aid in the recovery process. If so, we hope this information will lessen any fear you have about nerve blocks. And use this information as a starting point to discuss regional anesthesia techniques more knowledgeably with your anesthesiologist.

If you’ve had any experiences, good or bad, with regional anesthesia or nerve blocks, we would love to hear from you below. And please ask any questions we didn’t answer above.

Thanks again for visiting anesthesiamyths.com and stay healthy!  Feel free to leave a comment below or visit our forum for more discussion.

Dr. Joe

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Category: Regional Anesthesia

Comments (101)

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  1. Laura says:

    I had foot surgery at 1;00 PM today and my foot is just now waking up at 1:15 AM. It’s still quite numb but it’s beginning to itch and once in awhile I can feel an ache. I took a Percocet at midnight, thinking I wanted to stay on top of the pain so it wouldn’t creep up on me while I was sleeping, but here it is 1:15 and I’m wired.

    I can’t say enough good things about the block and the surgery. I received Versed and Fentanyl in the Pre-Op room and that’s all I know about the block. I then remember waking up and moving onto the operating bed but that’s all I remember about the actual surgery, too. It was a super easy surgery from my end and so far, an even easier recovery. (I had a 3 part surgery done for Hallux Rigidus, though, so I’m sure the pain will catch me tomorrow.)

    But I just wanted to write and encourage people to always take the block if offered. It didn’t hurt going in, though other blocks may hurt a little, but the long length of time you go without pain afterward is so worth it. Especially for a larger joint like a shoulder.

    • DrJoe says:

      I am so thankful that your surgery and anesthesia went so smoothly. Sounds like a home run to me :)

      We appreciate you letting everyone know what it felt like to have a nerve block. This is the EXACT sort of information that we hope to hear more and more about from others.

      Dr. Dave and I will learn more about how to perform our jobs better and others out there will be armed with more information about anesthesia. In turn, we hope this will lessen their fears.

      We would love to have you post your experience on the forum as well.

      Take care!

      • Tonya says:

        I had a nerve block to repair a fractured wrist yesterday now my right leg is numb. Is this normal?

        • David Draghinas says:

          Tonya,

          Thanks so much for your question.

          Leg numbness should not have anything to do with a nerve block on your arm/wrist. I don’t see how these would be related. You may want to contact your physician so they can figure out what is causing your leg numbness.

          Please come back and give us an update.

          Dr. Dave

  2. Wish you would have put in more information about symptoms of the nerve blocker wearing off.

  3. Vanessa Huckeby says:

    Hi Dr. Joe! I thought I’d share my experience with you. I had achilles tendon repair surgery done yesterday morning at 10am. I had a nerve block used along with general anesthesia. I didn’t feel any pain while being given the nerve block, and only a mild pinch like a regular shot as they numbed me a little before giving me the block. I was numb from my knee to my toes. I had some pain briefly when I awoke in recovery, but within 30 minutes or so, it was gone completely and I didn’t feel anything again until today (approx. 26 hours after surgery).

    I could tell the block was starting to wear off when I began to have some tingling in my toes, but still no pain. Then I began to be able to wiggle my toes slightly. The block wore off gradually over several hours – before I began to feel any pain.

    Having the nerve block was a Godsend! Not dealing with pain that first night made it sooo much better. Being able to recover from the anesthesia pain free makes it easier to deal with the pain when it does finally come around.

    • DrJoe says:

      Thanks so much for sharing your story! I am happy your nerve block worked well and that this was a good experience for you. It is great for everyone to read about a real world experience. Come back again :)

  4. susan says:

    My husband had a nerve block yesterday for shoulder surgery about 1:30 pm and now it is 10:30 am the following day but he still has some numbness in hand (can’t raise his hand up at wrist either) and in his arm but pain is evident in his shoulder so he’s taking pain pills. How long before all the numbness is gone?

    • DrJoe says:

      Susan,

      If feeling has returned to your husband’s shoulder, I would expect the numbness in his hand to wear off as we speak. The anesthesiologist must have put in a great nerve block! How is his pain now that he has starting taking the pain pills?

  5. Stephanie says:

    I’m having a total knee replacement in a few days. The surgeon told me that a femoral nerve block would be done and then a spinal block also. I googled the femoral block and just about passed out. I am so utterly terrified I am considering canceling the whole thing. Can I be put under general anesthesia and THEN be given the nerve block? I was told I would be given some relaxing meds & some pain meds prior to the block, but will I feel the needle? Will it hurt? I am so anxious over this I can hardly breathe.

    • Stephanie,

      Don’t pass out before your surgery!! :)

      You have come to the right place to ask your questions. Thanks for trusting us.

      First of all, you should speak with the anesthesiologist the day before your surgery. See this post for details. I think speaking with the anesthesiologist will calm some of your fears.

      I think the plan you were given for your anesthesia is an excellent one. This will provide for great pain relief.

      And when your femoral block is placed, most definitely you will be sedated and comfortable. Don’t worry. They will not get started with the nerve block until you are nice and relaxed. We want you to be relaxed while we do the block because it helps us put the medicine in the best spot.

      Can you be put under general anesthesia prior to the block? There is no standard answer for this. It is up to the comfort level of the anesthesiologist taking care of you that day. That’s why I think it is best to speak with them.

      But I can assure you that you will be given relaxing medicines prior to the nerve block. And femoral blocks work well for providing a good deal of pain relief after total knee replacements.

      Hope this helps. Come back and tell us how you did!

  6. Mishell says:

    Hi, I had the nerve block done on friday for surgery on my right achilles. I have all feeling back now and pain :( can u tell me when will the burning and pulsing pain start to wear off? I am taking pills for the pain every 4 hours as told by doctors, but I don’t want to be taking them long term as the pain sometimes in my calf and ankle is very painful? When should I be concerned about the areas where I shouldn’t be in pain and how many days till I should contact my GP if pain doesn’t ease?
    Thanks Mishell.

    • David Draghinas says:

      Hello Mishell,

      Thanks for your question. Generally, the pain and soreness improves with each passing day. I can’t give you a more definite timeline because things will depend on the extent of your surgery, you medical profile, your perception/tolerance of pain, etc. Be sure to stay in touch with your physicians if things seem to be moving in the opposite direction.

      Do you know what kind of nerve block you received? How would you rate that experience? Your experience may be valuable to others here that are considering nerve blocks as part of their anesthesia plan.

      I hope you your pain improves soon, and that you get back to “normal”.

      Dr. Dave

  7. I had my right ankle scoped 9 days ago with a nerve block. After surgery I couldn’t wiggle my toes or feel anything for about 24 hours. I have most of the feeling back below the knee except for my big toe and a little bit around my big toe. Is this something that I need to be concerned about or will it resolve over time?

    • David Draghinas says:

      Thanks for your question.

      Depending on the local anesthetic used, most nerve blocks last up to about 24 hours (but they can last a bit longer).

      At 9 days out, it would be a good idea to let your surgeon and anesthesiologist know. They will have the details about what was included in the block and what happened during surgery.

      As some general information, most residual numbness resolves over the ensuing weeks or months.

      I hope you get back to normal soon. Please keep us updated.

      Dr. Dave

  8. Trang says:

    Question: I currently have intermittent sharp pain in my right, lower back (1-injection site buttocks area) and pulsating ache/soreness in my right, groin area (3-injection sites).

    Surgery/Nerve Block History: Knee injury occurred on 3/17/13, during tag football that turned into a tackle.

    This is day 7, status post Right Knee ACL Reconstruction and Lateral Meniscus Repair completed with no complications on 4/30/13. I also have a partial MCL tear with pre-surgery physical therapy, 3x/wk. (15 sessions).

    I received a nerve block during general anesthesia with no pain experienced during the procedure. Surgery occurred at 7:30 am and completed at 8:45 am. General anesthesia started wearing off around 11:00 am and I was discharged around noon. By 2 pm my nerve block started to wear off and pain started to increse, as numbness subsided and sensation came back starting from my toes, gradually creeping up towards my thigh.

    Hydrocodone/Acetaminophen 10-500T prescribed for pain as needed. Medication did not work to relieve pain during the first 24 hrs. after hospital discharge.

    My current concern is longterm aching, soreness in groin area and pain in lower back, which I’ve correlated to the Nerve Block (symptoms did not exist prior to surgery). However, I have occassionally experienced shooting pain down right leg from lower back ever since receiving an epidural for 1st pregnancy in 1997 (symptom occurs couple times/year).

    Am I accurate to correlate current discomfort to nerve block and when should symptoms subside?

    Thank you for your time!

    Trang D.
    Nevada

    • David Draghinas says:

      Thanks for your question, Trang.

      It seems like you are pretty familiar with medical terminology. Are you in the medical field?

      I don’t quite understand what you mean by “1-injection site” and “3-injection sites”. But here is some information about the symptoms you describe:

      Aching and soreness in the groin area is not typical 7 days after a nerve block. If this continues to bother you, you should consider letting your physician know to make sure there isn’t something more serious going on (infection, hematoma, etc).

      The “shooting pain” you describe down the leg from the lower back sounds like sciatic type pain. Epidurals do not cause sciatica. This kind of pain can occur if a nerve is compressed or irritated (ie. as can occur from a herniated disk). Pregnancy causes weight gain and center of gravity changes that can impact the spine. Then during labor and delivery, the legs, hips, and pelvis are stressed into different positions to help push the baby out.

      The type of back pain that can sometimes be seen with epidurals (typically at the site of epidural placement) usually resolves within a few days to a few weeks. And any sort of nerve damage with epidurals is extremely rare.

      I obviously can not speak specifically to your case over the internet, but I would be surprised if the pain you describe was due to the epidural.

      I hope this information helps and more importantly, I hope you feel better soon!

      Dr. Dave

      • Trang says:

        Hello Dr. Draghinas,

        Thank you for the quick reply. In response to your question, I do work in the medical field with limited experience. The knowledge I currently have has been gained during my injury and current recovery process.

        I apologize for the confusion about “injection sites.” During pre-op. the RN certified to give anesthetics informed me the injection sites for my nerve block would be in the groin area and sciatic (she pointed to right buttocks area).

        I haven’t received a f/u appointment with my orthopedic surgeon, so wondered if I could see where the nerve blocks were injected. I examined myself, hence noticing the needle point sites I presumed were the locations of the injections.

        I hope the above provides sufficient clarification.

        If the soreness and pain continues to exist by my appointment next Wednesday, then I will inform my physician.

        The good news is, this is day 9 status post surgery and symptoms have subsided. I’m already bending my knee at 90 degrees and I’m able to partially weight-bear.

        I appreciate having a forum like this to express what I’m going through, which provides a form of emotional catharsis, since this has been a traumatic experience.

        • David Draghinas says:

          I’m glad to hear that you are doing better, Trang.

          It sounds like you had two blocks for your ACL Reconstruction (which can be pretty painful to recover from): a femoral nerve block and a sciatic nerve block. Nerve blocks can be an excellent way to treat post operative pain, often allowing patients to start the rehab process as quickly as possible.

          It’s a good idea to inform your physician of any pain, soreness, or other “abnormalities” that are concerning to you. Communication and knowing what to expect (what is normal and what is not) in the recovery process is so important.

          I’m glad to hear that you are on your way back to normal.:)

          Looking back, is their any aspect of your “nerve block” experience that could have been improved? Is their anything you know now, for example, that you wish you knew prior to your surgery and anesthetic?

          Dr. Dave

          • Trang says:

            Dr. Dave,

            Thank you for confirming the types of nerve blocks I received.

            Thinking back at my nerve block experience, I would’ve liked more information about the risks and expectations, prior to the day of surgery. I had no idea nerve blocks were an option.

            Overall, I think the nerve blocks helped me recover with less pain and with out the need to rely on stronger pain medications than what was initially prescribed (Lortab 10-500).

            Even though my nerve blocks started wearing off sooner than I would’ve liked (within 4 hours after I woke up from general anesthesia), I’m glad I made the decision to receive the nerve blocks.

            Thanks again for your time and expertise.:)

            • David Draghinas says:

              I’m glad to hear that overall you had a positive experience.

              And thanks as well for your input regarding the information you received and how to improve it.

              Hopefully, this will help us improve the resources we have available here on this site.

  9. Bettye Columbo says:

    Hello,
    I had a nerve block on my shoulder today for rotator cuff surgery. It is working well but my hand is very warm. Should I be concerned or is this normal? Thanks so much.

  10. Scott says:

    I had ankle surgery done last Thrusday and had a block put in just behind my left knee. I was not told about any side affects or that it might not work at all and only signed the waiver after they had gave me numbing med thru my Iv. It took them a very long time (30 min at least) to preform this and it was extremely painfull. When I woke in the recovery room I was in the worse pain you could ever think of and it took them almost 3 hrs to manage my pain to an 7 or 8 on the pain scale. Would not wish such pain on anyone. The block was leaking fulid and blood continual and causing pain in the back side of my leg the whole next day until I demanded they remove it. Once they did the pain in my leg got better. I would never, ever recommend anyone getting this done, ever.

    • David Draghinas says:

      Scott,

      I’m sorry you had such a bad experience with your nerve block. In most cases, block placement is not very painful. And mild sedation can be given to help with patient comfort. When working appropriately, the block provides very good pain control, allowing the patient to take less IV pain meds (which can have side effects) and start the rehab process earlier.

      It also sounds like you had a nerve catheter placed, which apparently was not working as intended. Catheters, when working, can extend the duration of the block and provide extended pain relief.

      We are working on a more complete resource for nerve blocks. You mentioned you feel you did not have adequate information before the block. Now that you have gone through this experience, what information do you wish you had prior to your surgery regarding nerve blocks?

      Would pictures and diagrams explaining how a block is placed been helpful?

      Again, I’m sorry your experience was so negative. Hopefully, the information you share here will help us provide better resources for others.

      Dr. Dave

  11. Scott says:

    Dr. Dave,

    Thank you for your response. Yes pics and diagrams would probably help. I think I just had incompetent personal that preformed my block, the young guy that did that block seemed as if he was still learning how to do it properly.(very unsure about what he was seeing on the screen and where he was I’m relation to the screen) I think they should inform you a little better before just rushing into it. Thanks again for taking the time to respond and for being sincere in wanting to help, you don’t find that much any more.

  12. Great information listed here. I didn’t know anything about this and was not aware they were intending on this for of anastesia-was told it should where off 4-6 hrs after I returned home but 12 hrs later still can wiggle my toes. So, my question now knowing I shouldn’t be completely concerned with that util 9 days–is how do I know that my extremity is okay as far as color, temperature and/or is it okay for me to move the toes with my hands to keep the muscles in shape?

    • Cynthia,

      Thanks for sending your comments. By this time, your nerve block has likely worn off :)

      However, I would like to know what type of surgery you had. That will help me answer your question. But in general, it is okay to move your toes. And your extremity should not appear different in color than the non operative side (unless it is the area surrounding the surgical incision of course).

      How would you rate the nerve block experience? Are you happy you had a nerve block? We are considering writing a nerve block guide for patients.

      Look forward to hearing back from you.

      • Sc@rf8ce75! says:

        It still has not worn off yet. I had surgery on left ankle to fix ligament & lesion.

        The experience at this time I am not excited but if my leg returns from deep sleep I will more than likely be okay. Until then I’m very nervous… As far as the procedure it wasn’t bad at all.

        Thanks for the follow uo!

        • It is very rare for the numbness to persist. Honestly, if your leg is in a deep sleep, that means you have an excellent nerve block. You should give your anesthesiologist a hug if you see them again :)

          I know it is a unique feeling for your leg to be asleep. But the sensation will come back soon. Just make sure you start taking your oral medicines as the block is wearing off.

          Thanks for stopping by!

  13. Patricia Sartori says:

    I had a nerve block back in March 2013 for I was having a full replacement right knee surgery. Well since then I am experiencing groin pain after I sit too long and then I can’t get up without the pain shooting down my leg. Also my right inside thigh is still numb. What can be done for the groin pain?

    • Patricia,

      I am glad you found our blog. I hope I can help a bit.

      The nerve block that you received was most likely a “single shot” block. This means that the medicine was injected as a one time dose and probably lasted a day or so. Does this sound familiar to you?

      If so, it is very rare for there to be any persistent numbness in the leg or any permanent side effect from one of these nerve blocks.

      In many cases, the anesthesiologist will use both an ultrasound picture machine and a nerve stimulator during the nerve block. These devices help us deliver the medicine in an effective but safe location.

      Ultimately, I would tell you that it is very unlikely for the discomfort and numbness you are feeling to be related to the nerve block. Your orthopedic surgeon is highly trained to handle musculoskeletal problems and will have the best answer for your question. And because they perform these type of surgeries often under general anesthesia and nerve blocks, they will be able to guide your treatment for this pain.

      Hope this helps and that you are dancing again soon :)

  14. Kelly says:

    I had my fourth c section in December. My blood pressure always tends to drop and as a result, I become very nauseated. This last c section, my blood pressure kept dipping very low in recovery and I kept forgetting to breathe. I felt as if I allowed myself to fall asleep, I would die. I had no strength to hold my son and was so sleepy. I had never experienced the forgetting to breathe aspect before. We would like to have another child but I’m terrified that I will stop breathing and die. I always have a spinal and get numbed with lidocaine first. They did a great job with keeping the nausea at bay but the forgetting to breathe and the dropping blood pressure scares me. What causes this?

    • David Draghinas says:

      Thanks for your question, Kelly.

      I have a couple thoughts in response to your comment. I obviously don’t know exactly what happened in your particular case. But some general information may help you figure out what was going on.

      First of all, if the spinal medicine creeps up a little higher, it can impact your rib cage and some of the muscles involved in breathing. Often times, you may “feel” like you can’t breathe even though you are breathing just fine.

      Secondly, the local anesthetic in the spinal that serves to “numb you up” is sometimes enhanced with narcotic type medicine. Anesthesiologists do this for several reasons: the dose of local anesthetic can be reduced, and we often add a special kind of morphine in the spinal for c/sections (this morphine lasts for about 24 hours and provides pain relief even after the numbness for the spinal wears off). These narcotics can potentially cause some respiratory depression.

      Thirdly, you may have been given sedatives or narcotics through the IV that could have made you feel drowsy (like you couldn’t breathe).

      These are the top three things that come to mind. Any of these things (or a combination of them) could have caused your symptoms.

      My suggestion is to definitely let your anesthesiologist know about this experience should you need a spinal and/or c-section again. Your anesthesiologist will consider your entire medical history before deciding on your anesthetic plan. Keep in mind that General Anesthesia, although still safe, carries a higher anesthetic risk during pregnancy (as opposed to that same patient not being pregnant). If your anesthesiologist still decides on a spinal, they may be able to adjust your dose so that you have a better experience.

      I hope this information helps. Best of luck to you.

      Dr. Dave

  15. Monica says:

    Dear Dr. Dave,

    I just had a total knee revision on 8/27/13. We started with an On-Q Pump (that I had a lot of pain with!) then, this has never happened before, I was forced by my PA-C and the Anesthesiologist (whom I never met) to have a spinal even as I refused the entire time. I know what my legal rights are so we don’t need to go there and I have already filed a complaint with my surgeon as this was the third knee replacement he’d done for me. The last one was 9/11 on the same knee.

    In 2/7/13 I had an L-4/L-5 fusion/decompression. It was in my file, but as it seems to be the case for me in the past decades, these doctors are trying to get as many surgeries in at a time to make as much money as they can with complete disregard for their patients and their lives. They also seem to have disregard for the patients safety which really scares me!

    I was seen by a surgeon I had (HAD) complete trust with and now I am left with no faith in even the hospital in which I had this done in. I am in constant pain, I cry nearly every moment of every day and I cannot move forward with therapy because of the PAIN. I don’t know what to do as I don’t trust them now and I have to stop taking pain pills! I’m just so miserable and not only will I NEVER recommend any type of nerve block EVER, I probably won’t ever have surgery again. I think I might rather die than go through this hell again. I’m sorry I sound so negative but I have nothing but death to look positive for.

    If anyone is considering a nerve block, DON’T!!!!!!!!!!!!!!!!!!

    Thank you so much,
    Monica

    • David Draghinas says:

      Monica,

      Thank you for sharing your challenging surgical and anesthetic experiences. I am sorry your experiences have been so horrific and that you are in so much pain.

      For most people, a nerve block can be a great way to decrease the pain of surgery without having to deal with the side effects of IV pain medication. And spinals/epidurals can also provide great pain relief below the level of the “block”.

      Placing a spinal (or doing any other procedure) on a patient that has refused is a different story. I won’t get into the “informed consent” issues here.

      I am sorry that your physicians and hospital system has lost your trust. My hope is that you still have a trustworthy personal physician that can help (perhaps in consultation with other specialists) get your pain under control.

      You are in our thoughts and prayers,

      Dr. Dave

      • Monica says:

        Dear Dr. Dave,

        You are such a sweet man! Yes, it has been horrific for me and I am trying, day by day, to get through this. We have done X-Rays on spine and now and I am waiting on an MRI that I have to have done, heavily sedated as I cannot lay flat for 45 minutes on an entirely flat surface.

        I have spoken to my surgeon (who is ultimately in charge of this debacle) and he has apologized beyond apology. He is a Dear man and I did trust him entirely before this procedure. I am learning to forgive, and I must, because I only hurt myself by holding onto this anger. We have come to some closure and understand that more conversation must be done in my case before this is finished.

        I wanted to let you know that I appreciate all you have to say and wish you were my doctor! :)

        Thank you so much!
        Monica

  16. Jonathan Lidz says:

    I had a ruptured Achilles’ tendon repaired last night and had the block. Still numb and zero post operative pain. Highly recommend the procedure. Will start taking pain meds as I begin to regain feeling in my foot b

    • David Draghinas says:

      Jonathan,

      Thanks for taking the time to comment and let the community know about your experience.

      I hope your recovery is as smooth and painless as possible.

      Take care,

      Dr. Dave

  17. lisa says:

    Just had a block done behind right knee before my lower tarsal tunnal release with plantar fasciotomy. Never felt a thing after some meds in If was out like a light also had general anthesia. When done toes felt weird but could wiggle slightly. Came home have had leg elevated 7 he’s now. Worried!!!! Can’t now feel toes or even move? Could this be normal ? Had block 11 he’s ago. Lisa

    • David Draghinas says:

      Thanks for your question, Lisa.

      Depending on the local anesthetic used, nerve blocks can last longer than the time frame you’ve indicated. But it would be unusual for the “block” to get MORE intense several hours after placement.

      It may be a good idea to run your symptoms by your physician.

      All the best to you. Please update us on your condition.

      Dr. Dave

      • lisa says:

        Doing better I think I just had some swelling . I think the block has saved me from having a lot of post op pain. Glad they did it. Lisa

  18. chris says:

    I had a nerve block for right shoulder rotator cuff surgery, now when I sleep or sit for awhile I have this burning sensation in my left thigh just below the hip. this has been happening for three weeks. any suggestions?

    • David Draghinas says:

      Hi Chris,

      I don’t think it’s likely the burning sensation you are experiencing in your thigh is related to the nerve block for your shoulder.

      Shoulder surgery is often performed in a “beach chair position”. It is possible, especially if your surgery took a little longer, that your pain could be related to the positioning. The good news is that most of the time, these burning sensations eventually go away.

      I hope you feel better soon.

      Dr. Dave

  19. Ryan says:

    Hi Doctors great post.

    IM a little concerned its late at night now. 8. Hours ago i had nerve block behind my left knee. woke up from ankle surgery and couldn’t feel any pain but could freely move my toes. Since then my toes are curling forward and i can just wiggle them a tiny bit but not back. When i woke up from surgery i had full use of my toes. Is this right? should it be getting more and more numb with less movement? its also very hot.

    Please help. thanks.

    • Ryan says:

      Just to say, my worries are over! I’m assuming the amount i had the leg up in the air, my circulation was poor and with the nerve block still in the system i had no movement (quite scary but i assume normal!) On a trip to the toilet with my leg down i could just about wiggle my toes again. Leg up and lost movement again.

      I would recommend the nerve block i think i had a good one! Around 26 – 30 hours of Numbness, but i must prepare people…when it wears off…Good luck! I Felt pain in the operated area quite bad, but now i assume i have adjusted and its quite manageable with meds regularly taken.

      Now just to find out when i can start taking my Omega 3 Supplement tablets and Mutli Vitamin to heal asap! Told to stop taking 2 weeks before but no mention of when to resume?!

      Thanks

      • David Draghinas says:

        Thanks for updating us, Ryan, and giving honest feedback on your experience.

        I’m glad the scary part of the numbness has gone away. 26 to 30 hours is a good length for a “single injection” nerve block.

        Check with your physicians, but I imagine they won’t have a problem with you taking your supplements soon.

        All the best to you,

        Dr. Dave

  20. Phewfta. I probably shouldn’t have read this post. I’m having a volar ganglion cyst removed (simple procedure) but I pass out/vomit at the sight or thought of anything to do with blood or needs. I’m concerned that if I’m “awake” with a nerve block I’ll have the same problem while they do the surgery. Probably should just leave the cyst :o.

    • David Draghinas says:

      Thanks for your comment. Unless there’s some reason to avoid general anesthesia, I don’t think you will be offered a nerve block by your anesthesiologist for this procedure.

      Should you ever need a nerve block, however, it is typically done with some sedation. And you definitely do not need to be looking anywhere near where the block is being performed (sometimes this is impossible anyways).

      But if there’s a chance you could pass out at the sight of any blood or needles, it would be a good idea to mention this when it’s time to get your IV. Rarely, I’ve had this happen with a few patients and it’s always helpful to have some notice beforehand.

      All the best to you. Please let us know how you did.

      Dr. Dave

  21. Mary albelda says:

    Hello! My husband recently had an ACL reconstruction, was sent home w/ an onQ nerve block. I pulled the block out as instructed once the meds ran out yesterday afternoon which was post op day#3. We are managing his pain w/ Norco. The only thing “new” he is feeling now is a burning sensation in his knee cap. My initial reaction was to check the sites for any infection, which I did. Everything looks good. Is it normal to have the burning feeling, I know that “burning” pain is associated w/ nerve pain. Is this an initial reaction to the nerve block wearing off? My husband states that the numbness is gone already and the sensations on his leg is back.

    • David Draghinas says:

      Thanks for your question, Mary.

      “Burning pain” is not “normal” for a nerve block. If your husband is still feeling this sensation, he should let his doctors know about it. They will be able to ask some questions in an effort to determine where this pain/sensation is coming from.

      Dr. Dave

  22. Hello! I was excited to find this website, I hope you can help. In January of this year I was thrown out of my truck onto my stomach and my bare heel was run over and crushed. A month later after an open wound had healed I had surgery. They placed a nerve block behind my knee which I imagine helped. The damage was so bad that I was on percocet for three months and then lortab which I’m still taking daily. I have developed CRPS so my doctor thought I might get some pain relief if he took out the screws in my heel. I had the hardware removal surgery three weeks ago, with another nerve block placed in the same area as before. This one really helped the pain but the top of my foot and a few of my toes are still numb. It happened the first time also and when I had my second surgery last month my big toe was still a little numb from my first surgery eight months ago. I am currently being seen at a pain management clinic and they want to try a sympathetic nerve block on me. I’m not really sure how my body will respond. Will my heel just go numb, will the numbness on the top of my foot ever go away? I haven’t been able to walk since my accident in January. My heel is very sensitive to the touch, and my foot is still swollen. At this point I can’t imagine being abe to put on a shoe and walk again. I have so much nerve damage that if this sympathetic nerve block will help then I will try it but I’m afraid of putting more nerve block medicine in my body. Do you think it will help and is it different than the nerve block I received during my surgeries? Thank you for your time I’m sorry my post was so long!

    • Hi Kellie,

      Thanks for sending us your question. It sounds like you have been through a lot since your accident in January.

      I am glad you are seeing a pain management physician. They are experts in the treatment of CRPS and are the physicians that perform sympathetic nerve blocks. I have never performed one of these blocks myself, but I know they are definitely used as a treatment option for CRPS.

      A sympathetic nerve block is different from the regional nerve block you received behind your knee. That was most likely a sciatic or popliteal nerve block. In any case, the sciatic nerve block will cause your foot to become numb and also cause temporary motor weakness in the lower extremity (this is all intentional). It is rare to have any prolonged numbness or motor weakness in the extremity after the nerve block medicine wears off — usually in a day or two.

      A sympathetic block on the other hand should not induce numbness in your foot. It is used to treat pain and as such, will hopefully provide you with some relief (or total relief!).

      My advice would be to discuss two things with your pain management doctor. First, let him / her know you are concerned about having a nerve block performed because you have had nerve block medicines in the past. And also, I would discuss the numbness in your toes with him / her.

      Best of luck to you. Hope this helps.

  23. Mike says:

    I had acl replacement with a patella graft about 6 days ago. Along with meniscus repair. I had a femoral block. My problem is I have a numbness, tingling, burning in my inner thigh that travels from the groin all the way to the knee. Any advice would be greatly appreciated.

    • Hi Mike,

      Sorry to hear about the numbness and burning pain you are having. For ACL replacement surgery, surgeons typically request a femoral nerve block to help with post-op pain management. Was the top part of your thigh numb for a couple of days after the surgery from this block?

      In any case, it is rare for there to be persistent numbness or tingling in the extremity after the nerve block medicine has worn off. The medicine we place for nerve blocks typically lasts anywhere from 12 to 36 hours. Since you are now 6 days out from surgery, I would expect this medicine to be out of your system.

      Have you had your post-op appointment with your surgeon yet? If you have, I would let your surgeon know what you are experiencing. If not, make sure you mention it at your post-op appointment.

      Let us know how it turns out.

  24. Hezekiah says:

    Hi! I’ve seen a few posts about the time of the block, but none in relation to how long it was SUPPOSED to last. I got my block around 1pm yesterday (however it took probably an hour before I couldn’t move my toes) the surgery/General anesthesia happened at 3 (the surgeon was held up). I was done with surgery/woke up around 4:30pm. They told me the block would wear off that night, and to start taking Percocet as soon as I had any tingling to stay ahead of the pain. I had some tingling in my my foot (maybe for a minute, rather dull, happened about 3-5 last night) but never in my toes. I’ve been taking 2 Percocet every 4 hours to stay ahead of the pain. However, they said the block would wear off last night, and it’s now 7:44 the next morning and I still can’t move my toes at all. My surgery involved them moving my first and second metatarsals into place as they were partially dislocated (the surgeon said the first metatarsal was subluxed before the surgery started, but told my wife after the surgery he had to pin the first two), and then put pins in them to hold them in place.

    They didn’t give me information about contacting the anesthesiologist, that I remember. I can contact the orthopedic specialist, but I didn’t think he would .

    Anyways, is it worth the hassle trying get ahold of the anesthesiologist? It ĥasnt been 24 hours yet. But they told me it would wear off last night. How much is that a generic estimate? I assumed I would be able to move my toes when it wore off. How long do you think I should wait until it’s reason for concern?

    Thanks

    • David Draghinas says:

      Thanks for your question, Hezekiah.

      How long your block will last largely depends on the type of local anesthetic that was used. It’s hard to give you an estimate without this information.

      However, if you are still experiencing the effects of the block, it would be a good idea to get in touch with your surgeon. He/she could guide you as to whether your symptoms are normal, or if anything else needs to be done at this point.

      I hope you get back to normal soon.

      Dr. Dave

  25. I am concerned. I had surgery at 8 am yesterday to relieve a significant amount of hardware from my left foot. It is now about 4 30 am and my entire left leg and foot are numb. I also had general anesthesia and am taking percocet every 4 hrs as directed despite having no pain and complete numbness. I was told the numbness could last up to 24 hrs but I am getting concerned. It may not matter but I am female, 56, and only weigh 114. Oddly I cant sleep either. Also, I am all hyper up. Thoughts?

    • Hi Jane,

      Thanks for your question. It has now been two days since you had surgery and the block. How are you feeling now? It is not uncommon for the numbness to last beyond 24 hours (this is good!). However, it is concerning if the block persists beyond a few days in duration.

      It seems that you are doing all the right things to take care of yourself. Please give us an update.

      • Antoinette says:

        Hi Dr. Dave, I am concerned, I had surgery on June 10, 2014, fifteenth days ago. I am still experiencing numbness in my big toe, little toe, and along the outside of my foot under Little toe. I have the nerve blockage during surgery. I when home with the IV behind my right knee. Two days later my daughter remove the iv block medication. My feeling started to return in some of my toes and foot. The nerve block did help with my pain. But I am very worried that part of my foot, toes and lower part of my leg is still numb. Is this normal? I am also having pain from the cold air in my toes. By the way my surgery was to repair a split tear tendon. How much longer should I experienced numbness.
        Antoinette Hayes

  26. Beverly Constantino says:

    My husband had rotator cuff surgery in his right shoulder yesterday. He recieved a block for the surgery. That has completely worn off. Our question is when he woke up his left leg and foot were numb and it is still numb. We are a little concerned about this. It was a rather complicated surgery and he was in the OR for nearly 3 hours. Could this be related to the position they had him in for 3 hours? Should we call the doctor?

    • Hi there,

      Thanks for your question. I am sorry to hear about the numbness in your husband’s foot, but I am thankful his surgery went well. Yes, I would notify your surgeon of the numbness. It would be abnormal to have any persistent numbness in the foot after a shoulder surgery. Please let us know what you find out.

  27. Margarita Zuniga says:

    I had surgery on my ankle Feb 10, and was given a nerve block I had no pain for almost 2 days which was great and took Norco to control pain for only a few days afterwards. It’s been a little over 2 weeks since I had the surgery and I’m feeling some tingling and some burning sensation on the top of my foot as well as the top of my toes. Is this normal? How long till it goes away if it is?

    Thanks,
    Margarita

    • David Draghinas says:

      The tingling and burning sensation you are experiencing is not typical following a nerve block.

      If it doesn’t improve, it may be a good idea to have your doctor check it out. The good news is that any kind of nerve injury following a nerve block is typically not permanent.

      You could also get in touch with your anesthesiologist to see if there was any difficulty in placing your nerve block.

      I hope you feel better soon.

      Dr. Dave

  28. Laura Hamouch says:

    I had surgery on Friday February 28th and had local anesthesia I had my veins removed which had blood clots in them from the left leg calf. My foot and the side of my left leg is still numb I can move my toes but that’s it, it’s been very difficult to walk because I can not feel my foot just walking down the block is very tiring idk what to do the doctor said it will take time to wear off but I need to know when I can’t even make it to work I’m thinking about using a cane my foot is so numb I put pressure on it ask much as I can but nothing. And my foot feels so cold feels like its in ice I’m getting very frustrated at this point is there any advice you can give me ? Thank you

    • David Draghinas says:

      Thanks for your question, Laura.

      I hope that by now the numbness has mostly (if not completely) worn off. If it hasn’t, please be careful when walking as you may be prone to falling more easily. And if you are still experiencing these problems, it would be a good idea to speak with the doctor who administered that anesthesia and, possibly, have your physician examine you.

      Hope you’re doing better,

      Dr. Dave

      • Laura Hamouch says:

        Thank you for the reply, so it’s been almost 3 weeks that I had the surgery my foot is still numb but I can move my toes more and I can turn my ankle in a circle the worst part a week after my surgery i sprained my ankle bc it’s so numb I’m still very frustrated next week probably going to see a neurologist for now I’m wearing a ankle brace for support

  29. Trudy says:

    Hello my name is trudy. Yesterday at 12 I had an acl reconstruction that lasted until 2. I woke up feeling great and couldn’t feel my leg. I got home around 3 and took about a 2 hour nap (with my prescription of hydro also) and woke up being able to feel my foot. I could move all my toes and I had complete feeling. I went to bed last night not feeling my knee and woke up at 4 being able to feel my knee calf and feet. I thought my nerve block would help more with the pain even with medication. Is there any point to keep it in if it isn’t numbing what I need numbed?

    • David Draghinas says:

      Thanks for your question, Trudy.

      It sounds like you had a nerve block with the placement of a nerve catheter. It would be smart to check with your physician before removing the catheter.

      He/she will be able to tell you how long the medicine for the catheter is supposed to last. There is a possibility that the tip of the catheter has moved and is no longer depositing medicine next to the nerve. But it’s smart to speak with your physicians before acting.

      Let us know what you find out.

      Dr. Dave

  30. Jim Carbone says:

    I had rotator cuff surgery Wednesday on my right shoulder. I had the On Q nerve block and today, Saturday afternoon, am happy to say I had no pain at all. When my wife removed the nerve block from my back the only pain was the brief moment she removed the tape that was used to keep the skinny tube that the anesthesiologist inserts for the surgery. Honestly it is simply amazing how effective the block was. My right arm is still in a sling and my hand feels like I’ve slept on it and it’s asleep. It’s been about 3 hours since the blocks been removed and my hand still feels asleep, although I think it’s starting to awake. Extremely pleased so far and after the medication wears off I am hopeful my arm will awake. Doctor had given me Percocet 5 which I have not taken one yet. Yea! I’m gonna try over the counter ibuprofen unless the pain starts to increase too much. When the feeling comes back in my hand I will consider this an almost miraculous non pain surgery. I had a fairly involved surgery lasting about an hour including slightly shaving the bone and thought the pain would be horrible. Thankfully I was wrong. So far I would say the only downside there is, is the lack of pain and that could allow someone to perhaps not protect the area by being to mobile thus injuring the surgical area. Fortunately that has not been my case so far. Talk with your dr but for shoulder surgery I would say do it as long as your anesthesiologist knows his her stuff.

    • David Draghinas says:

      Thanks for your detailed comment sharing your experience, Jim.

      Many times, those with good results don’t bother to jump online and share. We tend to do that more when things have gone poorly.

      I always try to warn patients about bumping the affected limb when numb, and possibly hurting themselves, as a part of my nerve block talk when I get their consent for the procedure.

      I am so glad things went smoothly for you! All the best in your rehab.

      Dr. Dave

  31. julie says:

    I had rotator cuff repair last wed but was told by anesthesiologist right before surgery that I would not be given nerve block because I have MS.. he didnt go into why and I had already been somewhat sedated so I didnt have all my wits about me to ask more in depth. It was troublesome
    though as my orthopedic surgeon and neurologist and PCP all said I could get the nerve block. I guess it was for the best I just wish it all would have been worked out and communicated better. So, are people with MS not allowed to have nerve blocks prior to surgery and why? Thanks for any info…

    • David Draghinas says:

      Julie,

      Thanks for your question. I am sorry it took me some time to respond to your question. I was out of town with very little access to the internet.

      Performing a nerve block in a patient with MS can be a challenging issue and often comes down to the judgement and comfort level of the anesthesiologist. There isn’t a lot of good data out there on nerve blocks and MS, but here are some of the concerns for the anesthesiologist:

      Patients that already have pre-existing neurologic disease (such as MS) may be susceptible to having issues after the nerve block. Any kind of stress, trauma, or toxicity related to the placement of the block and delivery of the local anesthetic could potentially exacerbate the underlying disease and/or lead to a relapse of symptoms.

      Anesthesiologists also fear that any worsening of the MS or development of any nerve injury afterwards, even if not related to the nerve block itself, may be “blamed” on the nerve block afterwards.

      These are, I believe, the main two reasons why many anesthesiologists are hesitant to perform nerve blocks in patients with multiple sclerosis.

      What’s critically important, as you mentioned in your comment, is for the anesthesiologist to have good communication with the patient (and other physicians involved in their care) prior to surgery so that a good anesthetic plan can be designed.

      In the future, should you need surgery where a nerve block may be beneficial, it would be a good idea to try to speak with your anesthesiologist PRIOR to the day of surgery. Your surgeon should be able to facilitate this process.

      Thanks again for sharing your experience.

      All the best,

      Dr. Dave

  32. Carolyn says:

    I had a nerve block for surgery to place 2 syndesmotic screws in my ankle to repair a maisoneuve fracture. I didn’t not feel any numblness before surgery, and I told the anesthesiologist that I didn’t think the block was working, and he just said, don’t worry, we test it to make sure it is. When I awoke from the surgery, I had the worst pain imaginable. It felt like my leg was in a vise and someone had shot me through with two spikes with a nail gun. I could barely speak. The pain was managed by painful injections of something directly into both sides of my leg, possibly morphine, so that within 15 minutes it was under control. I’ve asked why the nerve block didn’t work and my surgeon just said he didn’t know.
    So that I can avoid a similar outcome should I ever need surgery that requires a nerve block in the future, I would like to know what was used and why it may not have worked. How can I approach my doctors to get this information in writing.

    • Hi Carolyn,

      Thanks for your comments. I am so sorry that the nerve block did not work for you. But I am glad you did get some relief with the subsequent injections.

      If you can get a hold of the anesthesiologist who took care of you, he or she should have no problem discussing the details of the nerve block with you. Patients have called me before to ask what medicines they were given.

      To be completely honest, though, the best way to approach this conversation is without anger or judgment toward the physician. I am not saying you would take this route, I am just giving you a heads up.

      In the current litigious environment of medicine, physicians are very nervous about litigation. I know this is always on my mind. One lawsuit could destroy your career, keep you from practicing in the city where you live, and undermine the credibility you have spent so many years trying to achieve.

      Dont worry though! We can handle it and know it is part of the job. Just trying to give you some perspective prior to calling your anesthesiologist.

      Best of luck to you.

  33. Just Me says:

    Can nerve blocks be done with MAOI patients? I’ll be on a protocol that allows me to remain on the MAOI up to and through surgery. I am excited at the prospect of this because this is pretty extensive surgery and I have a 2.5 hour ride home when I am discharged. My surgeon’s nurse said that they usually do this surgery outpatient with the nerve block to control pain at home the first night. I will probably be kept overnight because of the MAOI so she said that they probably will be willing to either place one that lasts several days (the catheter kind I assume) or repeat the block prior to discharge. It sounds great but will the MAOI be a problem? My surgeon and his nurse are not up to date on MAOIs at all. My psychiatrist will educate them and connect the proper anesthesiologists with them soon but right now they don’t understand that they need to know about this as well as anesthesia because pain management can be tricky (I’m allergic to codeine and had a negative reaction to percocet in the past just to make it more challenging). In the meantime I’m anxious because I need to feel like things are under control and that there are plans to handle the MAOI in place. Again, anesthesia will be great once I am connected to the people who do MAOIs routinely but I have a pretty clueless dr. which makes me nervous.

    Thanks

    • David Draghinas says:

      Thanks for your question. I am not aware of any contraindications for nerve blocks in MAOI patients.

      There are two main issues with patients on MAOI’s and anesthesia. The first involves the potential for such patients to have exaggerated responses to certain drugs that are used to treat low blood pressure (eg. Ephedrine). Whereas in most people normal doses of this drug would bring the blood pressure back to a normal level, in MAOI patients, these same doses can lead to very high blood pressure.

      The second issue involves the use of Demerol (ie. Meperidine). This is a medicine in the same class as morphine that is used in the peri-operative setting to treat pain and/or shivering. In MAOI patients, however, a dangerous serotonin syndrome can develop if this drug is used.

      As you mentioned, one of the best things you can do is get your surgeon, psychiatrist, and anesthesiologist to communicate BEFOREHAND so that a great plan is in place for you.

      All the best with the upcoming surgery. You are in our thoughts and prayers. Please come back and let us know about your experiences.

      Dr. Dave

  34. Chris M says:

    Hello, 12 days ago I had surgery to repair the rotator cuff and the bicep tendon.
    The anesthesiologist used nerve block and told me that I’d be numb for about 12-18 hours.
    Well, 12 days later my fingers (especially the middle) and my palm are still numb and a little swollen.
    Today I had my first post-op visit and the physician’s assistant ( the surgeon won’t even come to talk to me) acted like I was making it up, she said that the surgeon did not do any “cutting” near the nerve.and couldn’t explain the numbness.
    Now I’m reading all these posts online about nerve block and I believe that it’s the cause of my numb fingers and palm.
    Is there anything i should be doing or is this going to go away by itself?
    And it can last up to how long???
    Thank you
    Chris

    • Chris,

      Thank you for sending your question to us. I wish the numbness and discomfort would go away for you.

      Prolonged numbness after a nerve block is a rare side effect. And it is even more rare for this persistent numbness to be permanent. If the numbness in your case is indeed secondary to the nerve block you received, I would expect it to eventually resolve. There is nothing in particular you can do to help the normal sensation to return.

      However, please follow the guidance of your surgical team with regard to post-operative care and rehabilitation. I know the rehab after a shoulder surgery can be tough and demanding. But it is very important. When you do get a chance to meet with your surgeon, explain what you have been feeling (or not feeling). He or she will obviously know exactly what occurred during surgery, and if there is anything else that can be done to help.

      I really hope this helps. Please come back and let us know how you are feeling.

    • Christos Makridis says:

      Hello, this is an update to my previous comment on May12.
      Now it’s been 3months and one week since my shoulder surgery (with the nerve block) and my fingers and hand are still numb.
      Shoulder therapy isn’t helping with the numbness .
      My doctor says it is a “rare complication” wants to send me for an electromyogram to check the nerve.should I go see a neurologist or leave it up to my doctor??
      Also,
      Just how rare is this and what are the chances of recovery if any?

      Thank you
      Chris

      • David Draghinas says:

        Christos,

        Very sorry we’re not hearing better news with your update.

        Permanent nerve damage is a rare complication of nerve blocks. And there are folks that do improve 6 months, one year, etc. after their nerve block. My hope is that you are one of those persons that continues to get better and better.

        I can’t really advise you on which doctors to use as you proceed. Perhaps you can get the electomyogram and ALSO consider seeing a neurologist. My guess is the neurologist may order an electromyogram themselves, and if you already have one, they will certainly study its results as part of your evaluation.

        Dr. Dave

  35. Deidra says:

    8 days ago I had 24 screws and 2 plates removed from my tibia and fibula. After I woke from surgery the pain medicine I was receiving was helping much. I was offered a nerve block and went for it. Well my inner and front of my thigh is still numb down past my knee all on the inside I mentioned it to the physicians assistant and she kind of blew it off. I can’t say it’s actually numb cause I have feeling but it’s like stinging and it’s kind of painful to rub or touch. One of my questions is, should i still have the numbness and weird feelings.? Well I was reading some of the other post and reading where people were receiving their blocks for things. I got my nerve block in my groin was that right place?

    • Hi Deidra,

      Chris’ question below is very similar to yours. Sorry to hear about the discomfort you are having.

      Persistent numbness is rare after a nerve block. And it is even more rare for any numbness to be permanent. In your case, this stinging and pain to the touch is abnormal. This is not something that I would expect after a nerve block. Please mention this again to the physician assistant and the surgeon if you are able to speak with him or her. They may have better insight and a plan to help.

      You must have had a severe injury to warrant that type of surgery on your ankle. Was there any trauma to the upper part of your leg during this accident? Any muscular injury in this area that you are aware of?

      In response to your second question, there are several nerve blocks that can be used to help with post-operative pain after foot and ankle surgery. One of these nerve blocks, is often a femoral nerve block. It would be very common for this femoral nerve block injection to be performed in the groin area.

      Hope this helps. How are you feeling today?

      • Deidra says:

        I will give them a call in the morning. Today is the same as yesterday. I have no pain from my ankle or my shin at this point just my thigh. I got stepped on by a hackney pony in July and she broke both sides of my ankle and part of my shin there was no muscular injury or trauma in my thigh when it happened. It was brutal but the metal was causing a lot of discomfort. I will call my doctor office tomorrow though and see what they say. I may be able to get an appointment with my family doctor in the morning do you think they would be of any help? My surgeon is in surgery Tuesdays and Thursdays

        • That sounds like a brutal injury! How is the pony?

          It wouldn’t be a bad idea to see your family doctor tomorrow if you can get an appointment. Often different modes of therapy can help with pain, including massage, local numbing creams, hot / cold therapy, anti-inflammatory medicines, and other types of medicine such as gabapentin. Your family doctor can examine you and determine what the next best plan will be to help with this discomfort, taking into account your past medical history / treatments / current medications / and allergies. Definitely follow up with your surgeon as well.

          • Deidra says:

            The pony is great. But I won’t be riding any time soon. This has steered me away. But I will give them a call and let you know what they say. Thank you!

  36. Maria Williams says:

    Aloha!
    Is it better to have an EMG to define muscle nerve damage before the nerve block procedure? I’m scheduled for Tuesday 20 May 14…Thank You!

    • David Draghinas says:

      Hi Maria,

      I’m sorry I couldn’t get back to you sooner.

      People typically do not get an EMG prior to a nerve block. If you do have some underlying nerve damage, it may be beneficial to get a neurologist and your anesthesiologist involved prior to surgery.

      How did your surgery go? Did you end up getting a nerve block?

      Dr. Dave

  37. sam says:

    i had ankle arthoscopy to clear out impingement and to remove a pin from previous surgery. I also have CRPS. I was in so much pain after i woke up they gave me a block behind the knee, and i have had no pain since. Bad thing which is really starting to concern me is they said it would last 12 hours and it is almost 21 hours later now. Foot is very hot and discolours dark red / purple when not evelavted, and have no movement at all below the knee or any feeling either. Can’t wiggle toes or foot at all it just flops about. Should i be calling them?

    • David Draghinas says:

      Hi Sam,

      Thanks for your question. Yours is a complex history (with the CRPS), and some of your symptoms are concerning.

      It would be smart to call your physician immediately, to make sure there isn’t something serious going on.

      Please come back and update us on your situation.

      Dr. Dave

  38. Rachel says:

    Hello,

    I came across your page while researching ankle blocks…I had surgery three days ago, and received an ankle block. It has now been over 72 hours and my entire foot is completely numb. Obviously this is great in terms of post op pain, but should I be concerned that it’s lasting this long??? Thanks!

    • David Draghinas says:

      Rachel,

      I am sorry I couldn’t reply to you sooner. How are you doing now? Has the numbness gone away?

      While three days is a long time for most blocks, there are certain newer medicines that can last several days. I hope you are doing well. Please update us when you have a chance.

      Dr. Dave

  39. Lisa says:

    Dear DR Dave,
    I had surgery yesterday at HSS on a completely severed Achilles’ tendon. I opted for the nerve block along with the spinal and light propofol. It is now about 16hrs post surgery and my leg is still numb, although I am feeling a sore sensation at the incision location. I could wiggle my toes downward in recovery and can still do that now–even feeling a little more of my lower foot pad this morning. The leg area under my knee about an inch or so is not numb and I can feel pressure when pressing on leg at top under cast. Does this all seem typical? I get a little concerned–as I am so happy to not have intense pain yet, but it is an odd feeling for your leg to be numb. What types of sensations will I feel when my foot and leg begin to awaken?

    Warmly,
    Lisa

    • David Draghinas says:

      Hi Lisa,

      Thanks for sharing your experience with our community.

      Depending on what kind of medicine was used in the nerve block, the block could last for quite a while. You should consider contacting your anesthesiologist to discuss the length of the nerve block if you are still experiencing some numbness.

      But as the block wears off, the sensation and movement of your leg and foot should slowly return to normal. This likely has already occurred. Maybe you can share with our audience what it was like to get the “feeling” back in your lower extremity.

      All the best,

      Dr. Dave

  40. Colin says:

    Had hip replacement 3 years ago had pain in me ankle ever since because they pull me leg to try levling as it was shorter now had pain block done I was wondering how long this numbness last and I am struggling to put weight on it any advice would be so helpful thank you

    • David Draghinas says:

      Collin,

      Thanks so much for writing to us with your question.

      It’s difficult to give you a specific response because we don’t have details on the nerve block itself. In general, however, most “single injection” nerve blocks may last anywhere from about 8 hours to about 24 hours. If certain “additives” are included in medicine, perhaps a little longer.

      Always be careful with a limb that is numb, as you may not be aware you are “bumping” it. And always be careful when you first try to walk after a nerve block; you may still have some residual muscle weakness even when you think the nerve block has worn off.

      All the best,

      Dr. Dave

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