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Nerve Blocks

Medial branch, occipital & peripheral nerve blocks in Midtown NYC. Ultrasound-guided pain relief from a board-certified physician. Same-week visits.

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At Modal Pain Management in NYC, we specialize in precision nerve block treatments under the care of Dr. Alex Movshis, a leading expert in non-surgical interventional pain management. Nerve blocks are versatile procedures that interrupt pain signals traveling from an injured area to the brain, providing targeted relief without surgery. By blocking specific nerves with carefully placed injections, we can achieve significant pain reduction while preserving other sensations and motor function. Nerve blocks serve dual purposes in our practice: diagnostically, they confirm the exact source of your pain, and therapeutically, they provide sustained relief that enables you to return to daily activities and participate fully in rehabilitation. Whether you’re managing acute pain from recent injury or chronic pain from longstanding conditions, nerve blocks offer a minimally invasive pathway to meaningful relief in the New York City area.

How Nerve Blocks Work

Nerve blocks function by delivering local anesthetic medication directly to the nerve or nerve cluster responsible for transmitting pain signals from your affected area. When the anesthetic reaches the nerve, it temporarily blocks the electrical signals that the nerve uses to communicate pain sensations to the brain. Our team uses advanced ultrasound or fluoroscopic guidance to ensure the medication reaches the precise location, maximizing effectiveness while minimizing discomfort. Different types of anesthetics are selected based on the desired duration of relief and your specific condition. Some anesthetics provide relief lasting hours to days, making them ideal for diagnostic purposes, while others combine longer-acting medications that extend relief for weeks or even months. The procedure itself typically takes between ten and thirty minutes depending on the complexity and type of nerve block being performed. Dr. Movshis personalizes each treatment plan, selecting the anesthetic combination that best serves your pain management goals.

Types of Nerve Blocks We Offer

Our comprehensive nerve block offerings address pain across different regions of the body. Occipital nerve blocks target headaches and migraines by blocking nerves at the base of the skull, providing relief for patients who have exhausted other treatment options. Stellate ganglion blocks address pain in the upper extremities, chest, and head by blocking the sympathetic nervous system’s role in pain transmission. Intercostal nerve blocks treat pain along the ribcage and chest wall, commonly used for post-surgical pain, rib fractures, and thoracic conditions. Medial branch nerve blocks target the small joints of the spine, offering relief for patients with facet joint arthritis and mechanical back pain. Peripheral nerve blocks address pain in the arms, legs, hands, and feet by blocking individual nerves that supply those areas. Each block type serves specific anatomical regions and conditions, and our diagnostic evaluation determines which approach will be most effective for your particular pain problem.

Conditions Treated

Nerve blocks effectively treat numerous acute and chronic pain conditions that limit quality of life. Chronic headaches and migraines, particularly those resistant to preventive medications, often respond excellently to occipital nerve blocks. Back and neck pain stemming from facet joint arthritis, disc herniation, or post-surgical complications can be addressed with medial branch blocks or other spinal nerve blocks. Patients experiencing complex regional pain syndrome, a condition involving limb pain disproportionate to the initial injury, frequently benefit from sympathetic nerve blocks. Post-operative pain management represents another important application, allowing patients to minimize opioid use during recovery while maintaining comfort for physical therapy. Additionally, nerve blocks address peripheral neuropathy pain, shingles pain, and pain from conditions like reflex sympathetic dystrophy. Our diagnostic nerve blocks help establish which nerves are responsible for your pain, ensuring subsequent therapeutic injections target the correct structures.

What to Expect During the Procedure

When you arrive for your nerve block procedure at our NYC facility, you’ll be positioned comfortably to allow Dr. Movshis access to the target nerve or nerve cluster. The skin over the injection site is cleaned thoroughly and typically numbed with a small amount of topical anesthetic. Using real-time ultrasound or fluoroscopic imaging, Dr. Movshis carefully advances the needle to the precise location of the nerve, ensuring accurate placement while minimizing tissue trauma. Once the needle position is confirmed through imaging, the anesthetic medication is delivered slowly to block nerve conduction. Most patients report minimal discomfort during the injection itself, particularly given the numbing effect of the topical anesthetic. After the procedure, you’ll rest briefly in our recovery area before being discharged home with detailed post-injection instructions. You can typically resume light activities immediately, though we recommend avoiding strenuous exercise for a few days to allow the medication to fully take effect.

Effectiveness and Results

Nerve blocks achieve rapid pain relief in most patients, with many experiencing significant improvement within hours of the procedure. The effectiveness varies based on the specific condition, the accuracy of needle placement, and the type of anesthetic used. Diagnostic nerve blocks typically provide hours to days of relief and serve the crucial purpose of confirming which nerves are responsible for your pain. Therapeutic nerve blocks offer more sustained relief, with many patients experiencing weeks to months of pain reduction. Some patients enjoy complete pain relief from a single injection, while others find that periodic repeat injections maintain their improvement. This flexibility allows us to adapt treatment to your body’s response and your evolving pain management needs. Following the block, many patients report not only pain reduction but also improved function, allowing them to participate in physical therapy and resume activities they previously had to avoid.

Treatment Planning

Dr. Movshis develops individualized treatment plans based on your specific pain diagnosis, medical history, and treatment goals. Before your first nerve block, we conduct thorough diagnostic imaging and physical examination to identify the exact source of your pain and confirm that you’re a suitable candidate for the procedure. If you’ve tried conservative treatments without adequate relief, a diagnostic nerve block may be recommended to confirm the pain source before committing to longer-acting therapeutic blocks. For patients with confirmed diagnoses, we discuss realistic expectations regarding pain relief duration and may recommend a series of injections spaced weeks apart for optimal benefit. We also integrate nerve blocks within a broader pain management strategy that may include physical therapy, medication adjustment, or other interventional procedures. Our goal is to provide sustainable relief that enhances your quality of life and reduces your dependence on medications with concerning side effects. Regular follow-up appointments allow us to assess your response and adjust your treatment plan as needed.

Insurance May Cover Nerve Blocks

We work with most major insurance providers. Let us verify your benefits before your first visit — at no cost or obligation.

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Why Choose Modal Pain Management?

Mount Sinai Fellowship-Trained

Board-certified with fellowship training in interventional pain medicine at the Icahn School of Medicine at Mount Sinai.

In-Office Ultrasound & Fluoroscopy

Image-guided injections performed in-suite — no hospital referral, no waiting weeks for outside imaging.

Same-Site PT, Chiro & IV Therapy

Coordinated non-surgical care under one roof at 369 Lexington Avenue — physical therapy, chiropractic, and IV therapy all on site.

Non-Opioid by Design

Treatment plans built around interventional, regenerative, and rehabilitative care — not pills.

Frequently Asked Questions About Nerve Blocks

A nerve block is an image-guided injection that delivers local anesthetic — sometimes combined with corticosteroid — onto or immediately adjacent to a peripheral nerve, a nerve plexus, or an autonomic ganglion. The local anesthetic temporarily interrupts pain signal transmission, producing both an immediate diagnostic result (does numbing this specific nerve relieve your pain?) and a therapeutic result (how long does pain relief persist after the anesthetic wears off?). When steroid is added, the therapeutic window typically extends to 6–12 weeks. At Modal Pain Management we perform every nerve block under ultrasound or fluoroscopic guidance — accuracy is in the 90s rather than the 50–70% range typical of blind landmark injections.

We perform the full range of axial and peripheral nerve blocks an outpatient interventional pain practice should offer: occipital and third-occipital blocks for occipital neuralgia and cervicogenic headache; sphenopalatine ganglion blocks for cluster headache and trigeminal V2 pain; trigeminal divisional (V1/V2/V3) and supraorbital/supratrochlear blocks for facial neuralgia; stellate ganglion blocks for upper-extremity CRPS, post-mastectomy pain, and select autonomic indications; intercostal nerve blocks for post-thoracotomy pain, rib fracture pain, and post-mastectomy intercostobrachial neuralgia; ilioinguinal, iliohypogastric, and genitofemoral blocks for chronic post-hernia and post-Pfannenstiel groin pain; lateral femoral cutaneous nerve (LFCN) blocks for meralgia paresthetica; sciatic-at-piriformis hydrodissection for piriformis syndrome; pudendal blocks for pudendal neuralgia; suprascapular blocks for shoulder pain; and superficial cervical plexus blocks for upper cervical and occipital pain referral patterns.

Duration depends on what is in the syringe and which nerve is targeted. A pure diagnostic block with bupivacaine produces 4–24 hours of relief — by design, because the question being answered is whether the right nerve was identified. A therapeutic block with bupivacaine plus corticosteroid typically produces 6–12 weeks of relief, sometimes considerably longer for occipital and intercostal blocks. Blocks that prove effective but yield diminishing duration with repetition are candidates for radiofrequency ablation, which can extend relief to 6–18 months.

Overlapping but not identical. A pure diagnostic nerve block uses only local anesthetic — its job is to answer 'is this nerve the source of the pain?' A therapeutic nerve block combines local anesthetic with corticosteroid and is designed to produce durable pain relief. An epidural steroid injection delivers steroid into the epidural space around a nerve root, not onto a peripheral nerve, and is therapeutic by design. The diagnostic-versus-therapeutic distinction matters for both clinical interpretation and insurance authorization.

Most commercial PPO insurance plans cover image-guided nerve blocks when ordered as part of a structured workup for chronic neuropathic or axial pain — typically with prior authorization. Modal Pain Management verifies your benefits before the visit so you know your responsibility in advance. We accept most major commercial PPO plans and do not participate with Medicare or Medicaid. Check your plan or call (646) 290-6660.

Image-guided nerve blocks are among the safest interventional pain procedures. Common minor effects include brief soreness at the injection site, transient numbness or weakness in the territory of the blocked nerve (which is the point of the block and resolves with the anesthetic), and a small risk of bruising. Serious complications — infection, allergic reaction, bleeding, intravascular injection, and lasting nerve injury — are rare and reduced further by ultrasound and fluoroscopic guidance. Patients on anticoagulants are managed per ASRA guidelines, and contraindications including active infection, uncontrolled coagulopathy, and known anesthetic allergy are screened for at consultation.

Same-week consultation appointments are typically available. Once a block is indicated, prior authorization (for plans that require it) typically takes 5–10 business days, after which scheduling is generally within the following week. For diagnoses where the information from the block changes the entire treatment trajectory — meralgia paresthetica, occipital neuralgia, intercostal neuralgia, suspected CRPS — the diagnostic block is prioritized in the schedule.

Ready to Get Out of Pain?

Schedule a consultation with Dr. Movshis — same-week appointments are routinely available.

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