Find the source of your pain. Find the fastest path to lasting relief.
A nerve block is a precision, image-guided injection that interrupts pain signals from a specific nerve. The procedure serves two purposes in one visit: it confirms the source of chronic pain and, in many cases, provides weeks to months of therapeutic relief.
Nerve blocks are for adults in the Princeton corridor with chronic back, neck, knee, hip, shoulder, or sacroiliac joint pain that has not improved with physical therapy or medication. They are also used as the diagnostic step before radiofrequency ablation, and as a non-surgical alternative for patients hoping to delay or avoid joint replacement or spinal fusion. Discseel® evaluation is available for select discogenic back pain cases.
or call 609-588-8600 · Lawrenceville-area office
By the Pain Management Team at Performance Pain and Sports Medicine
Matthias Wiederholz, MD · Jade Nemeth, PA-C
Updated May 2026
On This Page:
- What Is a Nerve Block?
- How Nerve Blocks Work
- Types of Nerve Blocks We Perform
- Medial Branch Block (Spine)
- Genicular Nerve Block (Knee)
- Lateral Branch Block (Sacroiliac Joint)
- Femoral and Obturator Nerve Block (Hip)
- Suprascapular and Axillary Nerve Block (Shoulder)
- Conditions That May Benefit
- The Procedure: Step by Step
- How to Prepare
- What to Expect After
- Risks and Side Effects
- Diagnostic vs. Therapeutic Nerve Blocks
- What Happens Next
- Cost and Insurance
- Nerve Block Injections at Our Lawrenceville Office
- Frequently Asked Questions
Lawrenceville sits at the center of the Princeton corridor pharmaceutical and research industry, between New York City and Philadelphia, with a patient population that includes Bristol Myers Squibb researchers, ETS staff, Lawrenceville School and Rider University faculty, healthcare workers across Penn Medicine Princeton and Capital Health, and active-adult tri-state retirees. The unifying thread is years of high-functioning work and active living, often interrupted by chronic pain in the back, neck, knees, hips, or shoulders that no longer responds to medication and physical therapy. A nerve block injection can identify which nerves are carrying the pain and, in many cases, provide meaningful relief. At Performance Pain and Sports Medicine in Lawrenceville, Dr. Matthias Wiederholz, MD uses image-guided nerve block injections to pinpoint the source of chronic pain and guide each patient toward the most effective long-term treatment, exhausting non-surgical options first.
What Is a Nerve Block?
A nerve block is an injection of local anesthetic, sometimes combined with a corticosteroid, placed near a specific nerve that carries pain signals. By temporarily numbing that nerve, the procedure interrupts pain transmission from the joint, muscle, or structure it serves.
Nerve blocks have two related purposes. As a diagnostic tool, the block answers a clinical question: is this specific nerve the source of pain? If numbing the nerve eliminates or significantly reduces symptoms, the diagnosis is confirmed. As a therapeutic tool, the same injection (often with anti-inflammatory medication) can provide pain relief lasting weeks to months, especially for joint-related or inflammatory pain.
The Cleveland Clinic notes that nerve blocks are a common option for chronic pain that has not improved with conservative treatments, and may delay or prevent the need for more invasive procedures (Cleveland Clinic, Nerve Block Overview).
How Nerve Blocks Work
Each painful joint or structure in the body has a specific nerve supply. The medial branch nerves carry pain from the facet joints of the spine. The genicular nerves carry pain from the knee. The lateral branches of the dorsal rami carry pain from the sacroiliac joint. The femoral and obturator nerves carry pain from the hip joint capsule. The suprascapular and axillary nerves carry pain from the shoulder.
When a small volume of local anesthetic is placed next to one of these nerves, it blocks the electrical signal from reaching the brain, producing a marked reduction or complete elimination of the pain associated with that nerve.
Every nerve block at the Lawrenceville office is performed under live X-ray (fluoroscopic) guidance. Real-time imaging confirms that the needle tip is in the correct anatomic location, which is critical for both diagnostic accuracy and patient safety.
Types of Nerve Blocks We Perform
Dr. Wiederholz performs five categories of nerve block injection at the Lawrenceville office, each targeting a different region of the body.
Medial Branch Block (Spine)
A medial branch block is an injection placed near the small medial branch nerves that supply the facet joints of the spine. Each facet joint receives medial branch nerves from two spinal levels, which is why the injection targets specific nerve locations rather than the joint itself.
The primary purpose is diagnostic. International consensus guidelines recognize medial branch blocks as more predictive than intra-articular injections for identifying facet joint pain and selecting candidates for longer-term treatment (Cohen et al., Reg Anesth Pain Med, 2020).
Three spinal levels are commonly treated. Lumbar (low back) blocks are the most common, with research indicating that facet joints contribute to 27 to 40 percent of chronic low back pain cases (Van Oosterwyck et al., Life, 2024). Cervical (neck) blocks address chronic neck pain, which involves the cervical facet joints in up to 49 percent of cases, with false-positive rates of 25 to 63 percent on a single block, making confirmatory testing especially important (Manchikanti et al., Pain Physician, 2020). This pattern is common in pharma corridor researchers, attorneys, and healthcare staff whose workdays involve sustained seated and screen-facing posture. Thoracic (mid-back) blocks address mid-back pain that points to thoracic facet involvement.
When a medial branch block confirms facet joint pain, the next step is typically radiofrequency ablation, which can provide six months or longer of relief.
Genicular Nerve Block (Knee)
The genicular nerves are small sensory branches that carry pain signals from the knee joint capsule. A genicular nerve block targets the superior medial, superior lateral, and inferior medial genicular nerves, the three primary contributors to knee pain.
This block helps patients with chronic knee pain from osteoarthritis who have not responded to physical therapy, anti-inflammatory medication, or intra-articular injections. It is also used in patients who want to delay knee replacement, in active-adult retirees who want to stay on the tennis court or hiking trails, and in patients who are not surgical candidates due to medical comorbidities.
A systematic review of randomized controlled trials and retrospective studies concluded that both genicular nerve block and genicular nerve ablation effectively reduce pain and improve function in knee osteoarthritis, with minimal and transient adverse events (Toubasi et al., Cureus, 2025). In a placebo-controlled randomized trial, ultrasound-guided genicular nerve blocks produced statistically significant reductions in pain at 2, 4, and 8 weeks compared with saline (Shanahan et al., Arthritis Rheumatol, 2022).
A successful genicular nerve block also identifies patients who are good candidates for genicular radiofrequency ablation, a longer-lasting treatment option.
Lateral Branch Block (Sacroiliac Joint)
The lateral branches of the dorsal rami carry pain from the sacroiliac (SI) joint, the joint that connects the base of the spine to the pelvis. SI joint pain accounts for 15 to 30 percent of all chronic low back pain cases and is frequently overlooked in patients with stubborn low back or buttock pain (Buchanan et al., J Pain Res, 2021).
A lateral branch block is the diagnostic standard for confirming SI joint pain. The block targets the L5 dorsal ramus and the S1 through S3 lateral branches. If the block significantly reduces pain, the next step is typically radiofrequency ablation of those same lateral branches. A 2023 evidence review found that radiofrequency ablation following positive diagnostic lateral branch blocks is efficacious for SI joint pain, with cooled radiofrequency showing the strongest evidence (Szadek et al., Pain Pract, 2023).
Patients with a history of lumbar fusion are particularly at risk for SI joint pain because the joint takes on additional load. The Lawrenceville office sees this pattern often, especially in patients who have had prior spine surgery at Penn Medicine Princeton, Capital Health, or RWJBarnabas.
Femoral and Obturator Nerve Block (Hip)
Pain from the hip joint is carried by sensory branches of the femoral and obturator nerves to the anterior hip capsule. A femoral and obturator nerve block targets these branches to relieve chronic hip pain, most commonly from advanced hip osteoarthritis.
This block is useful for patients with severe hip osteoarthritis who are not surgical candidates due to medical comorbidities, who are waiting for hip replacement, or who prefer a non-surgical alternative. A randomized clinical trial of 44 patients with severe hip osteoarthritis who had failed conservative treatment found that obturator nerve block produced statistically significant improvements in pain (VAS) and function (WOMAC) at one and four months, with no severe adverse events reported (Crema et al., Acta Ortop Bras, 2023).
The procedure is performed under fluoroscopic or ultrasound guidance. As with other diagnostic blocks, a positive response may indicate that the patient is a candidate for radiofrequency ablation of the hip articular nerves for longer-lasting relief.
Suprascapular and Axillary Nerve Block (Shoulder)
The suprascapular and axillary nerves provide most of the sensation to the shoulder joint. A suprascapular and axillary nerve block targets these nerves to relieve chronic shoulder pain from rotator cuff disease, adhesive capsulitis (frozen shoulder), shoulder osteoarthritis, and post-surgical pain. Chronic shoulder pain is especially common in patients whose work involves sustained keyboard use, racquet sports, or repetitive overhead motion.
A 2025 systematic review of randomized controlled trials concluded that suprascapular nerve blocks combining local anesthetic with corticosteroid significantly reduce chronic shoulder pain at three months compared with standard non-operative care (Scattergood et al., Eur J Orthop Surg Traumatol, 2025). In an observational study of 71 patients with chronic shoulder pain, ultrasound-guided suprascapular nerve blockade produced pain reduction in 89.8 percent of patients at one month, with 43.7 percent achieving complete pain remission at six months (Sá Malheiro et al., Braz J Anesthesiol, 2020).
The block is often repeated as part of a treatment plan and can be combined with physical therapy to support recovery of shoulder range of motion.
Conditions That May Benefit
Nerve block injections may be recommended when imaging, physical examination, and a patient’s pain pattern point toward a specific structure as the source of symptoms. Lawrenceville patients commonly present with one of the following conditions:
- Spine (Medial Branch Block):
- Facet joint osteoarthritis, especially in patients over 50
- Chronic axial back or neck pain from sustained seated work (pharma research, legal, faculty, healthcare)
- Spondylolisthesis-related facet loading
- Persistent pain after spinal fusion
- Knee (Genicular Nerve Block):
- Knee osteoarthritis in active adults
- Chronic post-surgical knee pain after total knee replacement
- Patients who want to delay or are poor candidates for knee replacement
- Diagnostic step before genicular radiofrequency ablation
- Sacroiliac Joint (Lateral Branch Block):
- Sacroiliac joint dysfunction
- Pain after lumbar fusion (the SI joint takes on increased load)
- Chronic low back or buttock pain that does not respond to other treatments
- Hip (Femoral and Obturator Nerve Block):
- Hip osteoarthritis
- Patients awaiting hip replacement or not eligible for surgery
- Chronic hip joint pain after fracture or surgery
- Shoulder (Suprascapular and Axillary Nerve Block):
- Rotator cuff tendinopathy and partial tears
- Adhesive capsulitis (frozen shoulder)
- Shoulder osteoarthritis
- Persistent post-surgical shoulder pain
A careful clinical evaluation is always the first step in identifying the most likely pain generator and selecting the appropriate block.
The Procedure: Step by Step
Most nerve block injections take 15 to 30 minutes and are performed in an outpatient setting. Patients remain awake throughout. Sedation is available for patients who experience significant anxiety, though many patients complete the procedure comfortably without it.
- Positioning. The patient is positioned to provide the physician access to the area being treated (face down for spine and SI joint, supine for hip and knee, seated or face down for shoulder).
- Skin preparation. The skin over the injection site is cleaned with antiseptic solution and numbed with a small amount of local anesthetic.
- Image guidance. Using fluoroscopy (live X-ray), Dr. Wiederholz advances a thin needle to the precise location of the target nerve. Contrast dye may be used to confirm correct needle placement.
- Injection. A small volume of local anesthetic (sometimes combined with corticosteroid) is injected near the nerve. Multiple levels or nerve sites may be treated in a single session.
- Observation. The patient is monitored briefly and asked to perform movements that normally provoke pain. The response is documented in a pain diary that the clinical team provides.
The anesthetic typically takes effect within minutes, and most patients leave the office within 30 minutes after the procedure.
How to Prepare for Your Nerve Block
Preparation is straightforward, but a few steps help ensure accurate diagnostic results:
- Blood thinners. The physician may advise pausing certain blood-thinning medications several days before the procedure. Instructions depend on the specific medication.
- Fasting. If sedation is planned, the patient may need to avoid eating for several hours beforehand. Patients not receiving sedation typically do not need to fast.
- Clothing. Wear loose, comfortable clothing that allows easy access to the area being treated.
- Transportation. Arrange for someone to drive you home, especially if sedation is used or a lower extremity is being numbed.
- Pain diary. The clinical team provides instructions on tracking pain levels before and after the block.
The Lawrenceville office staff confirms specific instructions during scheduling.
What to Expect After
Pain relief from the local anesthetic typically begins within minutes and may last several hours. With longer-acting agents such as bupivacaine, some patients experience meaningful relief for several days. When corticosteroid is added, relief can last weeks to months as the anti-inflammatory effect develops.
Most patients return to normal activities the same day or the following day. Mild soreness at the injection site is common and typically resolves within 24 to 48 hours.
- Tracking your response matters. The clinical team asks patients to document pain levels carefully in the hours and days following the block. For diagnostic blocks, a 50 percent or greater reduction in pain is generally considered a positive response and guides the next treatment decision. For therapeutic blocks, the goal is sustained pain relief that allows the patient to participate in physical therapy and return to daily activities.
Patients should avoid strenuous activity for the first 24 hours, then resume their normal routine as tolerated. The office schedules a follow-up to review the pain diary and discuss next steps.
Risks and Side Effects
Nerve block injections have a strong safety record. A systematic review of more than 200,000 interventional spine procedures reported an overall infection rate of 0.04 percent for facet joint procedures (Santiago et al., Pain Physician, 2021). Across nerve block studies in the knee, shoulder, hip, and SI joint, reported adverse events are minimal and transient.
- Common (mild and temporary):
- Soreness or bruising at the injection site
- Temporary numbness in the area
- Mild headache
- Uncommon:
- Allergic reaction to the anesthetic or contrast dye
- Temporary increase in pain before improvement
- Vasovagal reaction (lightheadedness)
- Rare:
- Infection at the injection site
- Nerve damage
- Bleeding (more likely in patients on blood thinners)
Patients with active infections, bleeding disorders, or known allergies to local anesthetics should inform Dr. Wiederholz before the procedure.
Diagnostic vs. Therapeutic Nerve Blocks
Patients often ask whether a nerve block is meant to diagnose the pain or to treat it. The answer depends on the type of block and the goal.
- Diagnostic nerve blocks use only local anesthetic. Their purpose is to confirm or rule out a specific structure as the pain generator. Medial branch blocks and lateral branch blocks are primarily diagnostic, since their main role is to identify candidates for radiofrequency ablation. The numbing effect is temporary by design.
- Therapeutic nerve blocks add a corticosteroid for longer-lasting anti-inflammatory effects in addition to the immediate numbing. Suprascapular nerve blocks, genicular nerve blocks, and femoral and obturator nerve blocks for hip pain are often performed therapeutically, with relief that can last weeks to months.
Many nerve blocks serve both purposes simultaneously: the immediate numbing confirms the diagnosis, while the corticosteroid provides extended relief.
What Happens Next: From Diagnostic Block to Long-Term Relief
The next step depends on the response to the block.
- If the block provides significant relief (positive response): For spine, knee, and SI joint pain, Dr. Wiederholz may recommend a confirmatory second diagnostic block, typically using a different local anesthetic. This two-block protocol reduces false-positive rates and identifies the patients most likely to benefit from radiofrequency ablation.
A 2015 multicenter study found that patients selected through medial branch blocks achieved 50 percent or greater pain relief at three months post-RFA at a significantly higher rate than patients selected by intra-articular injection (P=0.041) (Cohen et al., Reg Anesth Pain Med, 2015). A systematic review of dual medial branch block protocols with strict relief criteria reported substantially better RFA outcomes than less rigorous selection (Schneider et al., Pain Med, 2020).
For shoulder and hip pain, the physician may recommend repeat therapeutic blocks combined with physical therapy, or, in select cases, radiofrequency ablation of the suprascapular nerve or hip articular branches. For patients whose imaging suggests discogenic back pain rather than facet pain, Dr. Wiederholz can also discuss the Discseel® procedure, which is performed at the Lawrenceville office and may offer an alternative to spinal fusion for select candidates.
- If the block does not provide meaningful relief (negative response): This is still a valuable clinical finding. It indicates that the suspected nerve is likely not the primary pain generator, allowing the physician to redirect the evaluation toward other potential causes.
Cost and Insurance
Most major insurance plans, including Medicare and New Jersey workers’ compensation, cover medically necessary nerve block injections. Coverage typically requires documentation that conservative treatments (physical therapy, anti-inflammatory medication) have not provided adequate relief.
Cost depends on insurance coverage, the number of nerves treated in a single session, whether the block is purely diagnostic or includes corticosteroid, and whether sedation is used. The Lawrenceville office team can verify benefits and provide a cost estimate before the procedure is scheduled. For coverage questions, call 609-588-8600.
Nerve Block Injections at Our Lawrenceville Office
Performance Pain and Sports Medicine performs nerve block injections at the Lawrenceville-area office at 3705 Quakerbridge Road, Suite 206, Hamilton, NJ 08619. The office sits on the Quakerbridge Road corridor that runs through both Lawrence and Hamilton townships, just off Route 1, making it easy to reach from Lawrenceville, Princeton, Trenton, Robbinsville, West Windsor, Hopewell, and Pennington. Patients also commute in from Bucks County, PA and the broader tri-state area when local options have not produced relief.
- Dr. Matthias Wiederholz, MD, the physician at the Lawrenceville office, is quadruple board-certified in Physical Medicine and Rehabilitation, Pain Medicine, Sports Medicine, and Anti-Aging, Regenerative and Functional Medicine. He founded Performance Pain and Sports Medicine in 2009 and is a Master Discseel® Instructor, having been the first physician to bring the Discseel® procedure to New Jersey. Dr. Wiederholz performs all nerve block injections personally, under live fluoroscopic guidance, with continuity of care from initial evaluation through follow-up treatment.
The Lawrenceville patient population reflects the unique professional and demographic profile of the Princeton corridor. Bristol Myers Squibb research scientists, ETS staff, attorneys and finance professionals commuting on the Northeast Corridor line, Lawrenceville School and Rider University faculty, healthcare workers at Penn Medicine Princeton and Capital Health, and active-adult retirees throughout Mercer County and Hunterdon County all present with chronic spine, knee, hip, and shoulder pain that has not responded to standard care. The office accepts most major commercial insurance, Medicare, and New Jersey workers’ compensation. It routinely handles referrals from Penn Medicine Princeton Medical Center, Capital Health Hopewell, RWJBarnabas, and primary care providers across central New Jersey.
In addition to nerve block injections and the full interventional pain management portfolio, the Lawrenceville office is one of the few practices in New Jersey performing the Discseel® procedure, an FDA-approved injectable biologic treatment for patients with chronic discogenic back pain who have failed conservative care and want to avoid spinal fusion. Dr. Wiederholz personally trains other physicians in the Discseel® technique.
To schedule an evaluation, call the Lawrenceville office at 609-588-8600 or contact us online. Nerve block injections are also available at the Houston, League City, and Baytown Performance Pain locations.
Performance Pain and Sports Medicine
Address: 3705 Quakerbridge Road, Suite 206, Hamilton, NJ 08619
Landmark: On the Quakerbridge Road corridor, just off Route 1
Major Cross Streets: Quakerbridge Road, between Lawrence and Hamilton townships
Parking: On-site parking available
Phone: 609-588-8600
Frequently Asked Questions
Is the nerve block procedure available in Lawrenceville, NJ?
Yes. Nerve block injections for the spine, knee, hip, shoulder, and sacroiliac joint are performed at the Lawrenceville office by Dr. Matthias Wiederholz, MD. All procedures use live fluoroscopic guidance and are completed as outpatient visits, with most patients leaving the office within 30 minutes of the injection.
Do you accept workers' compensation for pharma, healthcare, or contractor injuries?
Yes. The Lawrenceville office accepts New Jersey workers’ compensation and routinely treats injured workers from Bristol Myers Squibb, ETS, healthcare systems, and tri-state contracting employers. The office handles documentation and authorization directly with carriers.
Do you accept referrals from Penn Medicine Princeton, Capital Health, and RWJBarnabas?
Yes. The Lawrenceville office accepts referrals from Penn Medicine Princeton Medical Center, Capital Health, RWJBarnabas, and primary care providers across central New Jersey, Bucks County PA, and the surrounding tri-state area. Self-referral is also accepted for most insurance plans.
Are nerve block injections painful?
Most patients describe mild pressure or a brief sting when the local anesthetic numbs the skin. The procedure itself typically causes minimal discomfort. Sedation is available for patients who prefer it.
How long does a nerve block last?
Pure diagnostic blocks (with anesthetic only) usually wear off within several hours. When corticosteroid is added, relief can last weeks to months. Radiofrequency ablation, which follows positive nerve block testing, commonly produces relief lasting six months to a year or longer.
Can I drive home after a nerve block at the Lawrenceville office?
Patients who receive only local anesthetic at the injection site can usually drive home. Patients who receive sedation or have a lower extremity nerve block (knee or hip) need someone to drive them.
What if my nerve block does not work?
A negative result is still clinically useful. It indicates the suspected nerve is likely not the pain source, allowing Dr. Wiederholz to redirect diagnostic efforts toward other potential causes, including evaluation for discogenic pain that may be a candidate for the Discseel® procedure.
Does insurance cover nerve blocks in New Jersey?
Most major insurance plans, Medicare, and New Jersey workers’ compensation cover medically necessary nerve blocks. Prior authorization is often required. The Lawrenceville office team verifies coverage before scheduling.
What is the difference between a nerve block and radiofrequency ablation?
A nerve block uses local anesthetic to temporarily numb a nerve, lasting hours to months. Radiofrequency ablation uses controlled heat to disable the nerve’s pain-signaling capacity for six months or longer. A nerve block is typically the diagnostic step that identifies candidates for radiofrequency ablation.
Do patients travel to Lawrenceville from Pennsylvania or New York for these procedures?
Yes. Patients commonly travel to the Lawrenceville office from Bucks County, PA, Mercer County, and the broader tri-state area for both nerve block injections and the Discseel® procedure performed by Dr. Wiederholz.
Schedule Your Nerve Block Evaluation in Lawrenceville
For patients in Lawrenceville and the Princeton corridor living with chronic back, neck, knee, hip, shoulder, or sacroiliac joint pain that has not responded to conservative treatment, a nerve block injection may be the next step toward a clear diagnosis and lasting relief. Contact Performance Pain and Sports Medicine or call 609-588-8600 to schedule a consultation with Dr. Matthias Wiederholz, MD.
MEDICAL DISCLAIMER
This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. The information presented reflects an interventional pain management perspective and is intended to support, not substitute, your relationship with a qualified healthcare provider. Individual results vary based on diagnosis, pain duration, overall health, and response to treatment. Some procedures may not be covered by insurance. Treatment outcomes depend on proper patient selection and accurate diagnosis. Always consult a board-certified physician before pursuing any pain management treatment.
Performance Pain and Sports Medicine
Dr. Matthias Wiederholz, MD · Jade Nemeth, PA-C
Medically reviewed by Matthias Wiederholz, MD
Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Sports Medicine, and Anti-Aging, Regenerative and Functional Medicine
Last reviewed: May 2026
