A brachial plexus block is a targeted injection of local anesthetic around the network of nerves in the neck and shoulder that supply the arm. It is used to help diagnose the source of upper-limb pain and to relieve pain in the shoulder, arm, and hand.
OVERVIEW
What a brachial plexus block is and how it works
The brachial plexus is a bundle of nerves that arises from the lower neck (the C5–T1 spinal nerve roots), passes behind the collarbone, and branches out to carry sensation and movement to the upper limb. When these nerves are involved in a painful condition, a brachial plexus block can interrupt the pain signals traveling along them.
During the procedure, your physician at Columbia Pain & Spine Institute uses image guidance to place local anesthetic, sometimes combined with a corticosteroid, around the plexus. The anesthetic temporarily quiets the nerves so they stop transmitting pain. Depending on where along the plexus the medication is deposited, the block can be performed at the interscalene, supraclavicular, infraclavicular, or axillary level to match the area of your pain.
CONDITIONS
What a brachial plexus block commonly treats
This block targets pain in the shoulder, arm, and hand that stems from the brachial plexus nerves. It is most often considered for:
Commonly treats
For sympathetically maintained pain in the upper limb, your physician may also discuss a stellate ganglion block, which targets a related cluster of sympathetic nerves in the neck. This page is part of our plexus & ganglion blocks category; you can also review all of our interventional pain services to see how these treatments fit together.
WHAT TO EXPECT
Your brachial plexus block, step by step
Before
You will review your medications with our team, since blood thinners may need to be adjusted in advance. Plan to have someone drive you home, as your arm may feel weak or numb for several hours. You will be positioned to expose the neck or shoulder, and the skin is cleaned and numbed.
During
Using ultrasound and/or fluoroscopic (live X-ray) guidance, your physician advances a thin needle toward the brachial plexus and confirms correct placement before slowly injecting the medication. Image guidance allows precise targeting while helping avoid nearby structures. The injection itself typically takes only a few minutes, with the full appointment usually lasting about 30 to 45 minutes.
After and recovery
You will rest briefly while we monitor you, then go home the same day. Your arm may feel numb, heavy, or weak for several hours until the anesthetic wears off, so protect it from injury during that time. Any soreness at the injection site is usually mild. If a steroid was included, any relief from it may build over several days. Your physician will review how you respond and use that to guide the next step in your care plan.
RELATED PROCEDURES
Related nerve and plexus treatments
Stellate Ganglion Block
Targets the sympathetic nerves in the neck, often used for upper-limb CRPS and circulation-related arm pain. Learn more
Suprascapular Nerve Block
Focuses on a single nerve serving much of the shoulder, an option for localized shoulder pain. Learn more
Peripheral Nerve Block
A broader group of targeted injections used to diagnose and treat pain along specific nerves. Learn more
FAQ
Frequently asked questions
Is a brachial plexus block painful?
Most patients feel only a brief pinch and stinging when the skin is numbed. Image guidance helps your physician place the needle precisely, and the procedure is generally well tolerated. You may notice your arm becoming numb or heavy as the anesthetic takes effect.
How long does the relief last?
Duration varies from person to person and depends on whether the block is being used diagnostically or therapeutically and whether a steroid is added. A diagnostic block may provide only short-term numbing that helps confirm the source of your pain, while a therapeutic block may offer longer relief. Your physician will set realistic expectations based on your condition.
How do I know if this procedure is right for me?
A brachial plexus block is one option among many for arm and shoulder pain. The best way to find out is an evaluation with one of our physicians, who will review your history and imaging. Contact our Gresham office to learn more, or ask your referring provider to send a referral by fax.