Different Injections

[Emme80]

Hello all! I've been trying to look up a clear definition/better understand the difference between certain injections.(I saw a recent post about injections, but I'm still unclear, so I thought it best to ask on my own here) What is the difference between an occipital nerve block and a cervical epidural steroid injection ("CESI"?)?
I have 2 different pains-(but both a "pain in the neck! lol!). There's cervical pain and pain on the back of head/skull, which they're saying is (besides there being a "collected fluids" pouch causing pain) occipital neuralgia. I'll be having further testing/imaging done to address cervical problems correctly. My cervical pain was a killer before surgery and now (hoping&praying temporary), has worsened after surgery. But, I am told the Greater Occipital Nerve has become affected. It feels like I'm 1mo. post-op vs. 4mo. Ugh. Besides the back of my head/skull pain(right side of incision-the surgical complication there), my entire neck, from base of neck to straight under base of skull is in a bad way-but especially from under base of skull to half way down neck. It feels like horrible joint pain-grinding, sharp,knife-like, inflamed, angry, horrible. So, w/the post-op complication on the back of my skull, & worsening cervical pain...Im stressed & frustrated. It's all still so very...severely acute feeling & swollen. Ugh.So, I actually look forward to this nerve block if it will bring some much needed relief. But I'm unclear about facet joint injection!?!?
I ask b/c besides the Nerve Block, he mentioned something about epidural, facet injections to deal w/ cervical pain (after further imaging) as a possibility.
I am getting a second opinion on all of this too-as I'd like to make sure I'm treated properly. I'm still googling to figure out the differences..I really like to know what I'm getting into & have knowledge on my side before having anything done. I think I understand nerve block to be an injection around the nerve to block signal/pain. Yes? But, not quite understanding the difference between that & steroid epidurals.... Steroids used in both? Is it a difference between injecting around a nerve vs. joint? And, is one more painful than the other (I'm willing to do it, both) I absolutely fear&hate needles, like pass out fear, but I'll try anything, with caution)
Any enlightenment here would be great!
ThanK you for any help here! Much appreciated!
~emme~

[Emme80]

Thank You so very much Tuck!!! I appreciate your helping!
I guess I just don't know what I'm getting now. The injection I'm due to get on the Feb. 16th is what he said was an "occipital nerve block". We discussed my problem (greatttttttt intolerance/ major allergy w/Steroids) w/ Steroids, but he said it stays where he puts it, and doesn't go "through my system" like oral steroids. He said he would inject around the nerve and my head would be numb for a few hours. He said it would reduce the inflammation and block pain signal that are caused by this "Greater Occipital Nerve". He said that it could work for maybe 2 months, maybe 3 or longer. It's going to be done as an ultrasound guided injection. I had a ultrasound guided nerve block once 5+ years ago, on the back of my knee for a foot surgery-the numbness was .., well,,wow. Trying to walk in the house, on crutches, with a non-existent leg what interesting & challenging. Lol..I remember just giving up trying to walk w/the crutches, as I couldn't trust my foot hitting the floor and accidentally putting pressure on a limb that didn't work in any kind of a way. So, I sat on my butt and scooted myself down my hallway to my room. Lol...that was a mess but I'll say, when that nerve block wore off, I wished so badly for another one right then, right there.
The Dr. said the numbness would wear off after a few hours, but the "steroids and other meds. injected" would continue to reduce inflammation & block pain signals. So, now I'm not quite sure what I'm getting. I thought it was a nerve block- but if it needs to keep being done (as he indicated it would last for a few months) , does that mean the goal is to destroy the nerve? I know nerves grow back (I think the nerves in my foot are stillll growing back, some 5years later...lol.) think I read, back w/the foot surgery that nerves grow back at a rate of like...a mm a month. (wow, remembering that surgery & it seems my foot, the bones, tendons etc. we're all destroyed, dismantled, in order to have the proper and not deformed foot I have now!)
So a nerve block attempts to destroy the nerve? Be it permanently or as long as possible? He said it was a nerve block, but it's medicine injected "around" the nerve to disrupt pain signal. There would be steroids involved though to help reduce inflammation. We're dealing w/ the "Occipital Nerve" right now- dealing w/my cervical spine later (as I need further imaging to see what allll needs to be treated/how. As I'd surgery there as well as brain (sub occipital craniectomy).
Hmmm...my god, is it painful? I know one might think that someone who's had brain& spine opened and cut up, stuff removed, cut apart,brain pulled out of spine, etc.,( that whole procedure is just...yuk!) along with the pincushion I became the 2years leading up to it, would not be scared of a needle in the neck (oh my, is the "occipital" nerve block done ON/into head? vs. neck? Oh dear..), but I am already freaking out-I hate needles and cannot look at them. I suppose I won't have to "see" it though as I don't have eyes on back of my head. But still, I freak out over the Botox injections for migraines-I cry every time. No matter how many times I've had to go under knife, blood drawn, EMG tests...my god, a lot done over years but still, I cry over a simple sight of a needle and now I'm not sure what I'm getting done.
Is there such thing as both? As the explanation he gave sounds like the ESI, but called it a nerve block (occipital. The cervical will be dealt he/later).
I suppose I'll call and ask. But I know he said it's an Occipital Nerve Block" , but the explanation sounds like...both. :/
Thank again for your help...always appreciative.
~emme~

[Tuckamore]

Hi Emme,

I understand your confusion. It doesn't help that some practitioners use different terms to describe the same thing.

I'll do my best to explain the difference - but I'm not always good at explanations.

Nerve blocks may be performed by injecting chemicals or anesthetics to the area, or by deliberately cutting or damaging certain parts of the nerve. I assume your physician is talking about destroying the nerve, hence no more pain signals can be carried by that nerve.

An epidural steroid injection (ESI) injects a steroid into a location that is causing pain. It's purpose is to control local inflammation while also "flushing out" inflammatory proteins and chemicals from the local area that may contribute to and exacerbate pain.

Nerve Blocks and Steroid Injection are two different things. The Nerve Block forever destroys the nerve (any nerve). The Steroid Injection treats the nerve and surrounding area, it is not destroyed.  

Now words in front of these injections or blocks usually indicate the location where they are being injected. As an example, Occipital is the back of your head and Cervical is your neck (Cervical Spine).

I hope this helps.

My Best to You,
~Tuck