Hardware Block

What is a Hardware Block?

A hardware block is a minimally-invasive method to diagnose and treat chronic pain, especially for people who have undergone a spinal fusion surgery in the past and are suspected to have pain due to the hardware inserted from the previous surgery. 

A hardware block involves injection of a medication (anesthetic) into a particular region of your spine i.e., cervical, lumbar, or thoracic spine where the hardware is located. If you experience pain relief from the medication, it indicates that hardware may be the cause of your spine/back pain. If not, your doctor needs to evaluate other possible causes of your chronic pain. 

A hardware block provides effective results and most patients experience pain relief. However, some spine doctors and pain specialists prefer to keep the hardware injection as a last resort when first line treatments such as facet injections, epidural steroid injections, and radiofrequency ablation are not providing satisfactory results.

What are the Causes of Hardware Pain?

Hardware pain is seen in those people who have undergone a prior spinal fusion and have a misplaced, dislocated, infected or loose hardware in the form of a rod or screw that is causing pain in your spine/back. 

What are the Indications for a Hardware Block?

A hardware block is recommended if you have undergone a spinal fusion surgery and you develop chronic pain in the operated area after that. 

Hardware Block Procedure

A hardware block is an out-patient procedure. 

• You will sit or lie down comfortably to expose your spine. 
• Using fluoroscopic guidance, the site of the hardware is identified. 
• Next, a local anesthetic is applied or injected to numb the targeted area. 
• Then, a small needle is advanced into your spine under X-ray guidance until it touches the hardware surface. At this point, a small amount of local anesthetic called a nerve block is administered.

The entire procedure may take less than an hour.

Recovery and Care After a Hardware Block

After the hardware block has been administered, you are brought to the recovery area and monitored for pain relief. 

Some of the common complaints after a hardware block are headache, dizziness, tenderness around the injected area, and nausea. You will be given or prescribed medications to treat your symptoms to help reduce your discomfort.

Later, you can go home. After the hardware block is administered, for the initial 24 hours, you are advised to avoid physical activities and take proper rest.

You will be asked to return in a day or two for a follow-up appointment. You need to inform your doctor about the extent of pain relief and any possible side-effects.

What are the Risks and Complications of Hardware Block? 

A hardware block is a safe procedure. However, it may have certain risks and complications such as:

• Allergic reactions
• Infection
• Hematoma: blood collects outside the blood vessels

You must call your spine specialist as soon as possible if you experience any of the following symptoms:

• Fever above 101 degrees,
• Worsening pain after the hardware injection
• Excessive weakness
• Injection site redness or drainage

What are the Benefits/Advantages of a Hardware Block? 

A hardware block is a non-invasive procedure however, it is less painful due to two reasons:

• Use of small-size needle
• Short duration/quick procedure