At present, some lay doctors, due to the lack of systematic knowledge and training, they call themselves “closed therapy”. Some are used for local injection of a wide variety of drugs, this type of treatment although sometimes can relieve the pain of some patients, but also many complications and disputes, especially for the purpose of making money, abuse of treatment, so that the word “closed” adds a bad color. The name “closed therapy” is widely spread, so that some medical personnel and some patients have misunderstandings about the formal “nerve block”, and even have a fear of it. Some people think that the treatment of many chronic pains is “closed”, injecting, treating the symptoms but not the root cause. This statement is wrong. A nerve block and the difference between closed: 1, the mechanism of action is different: the original meaning of “closed” is through the proximal local injection of anesthetic in the lesion, in order to block the lesion from the site into the central adverse stimulus to interrupt the resulting vicious circle, the adverse stimulus closed in the local and conducive to the relief of the patient’s symptoms and the recovery of the lesion. This meaning emphasizes the role of “nerve reflex”. The therapeutic mechanism of “local block” is not only to block the pain sensation at the lesion site and the afferent of the undesirable stimulus, but also to interrupt the vicious cycle, more importantly, “local block” is to inject some effective therapeutic drugs directly into the lesion. These drugs have the effect of regulating the nerves and dilating the microvasculature of the lesion, and improving the blood circulation of the diseased tissue. These effects facilitate the absorption of inflammatory exudate cells and pain-causing substances, thus facilitating the recovery of the lesion. In addition, it also has the effect of direct treatment of sterile inflammation, reduction of adhesions and softening of scarring. Although the dose of “local block” is small, the local concentration of the drug is large, and it is in direct contact with the lesion, so it is not only effective and long-lasting, but also because the amount of drug going to the whole body is very small, so the reaction of the drug is small, and the side effects are also very low, and there is no need for daily treatment. It is also because the drug is directly injected into the lesion tissue local, distributed to the cardiovascular system and other parts of the body amount is very small, so some oral, intravenous drug administration contraindicated patients, under close observation can also be carefully applied to local injection therapy. 2, the use of different drugs: “closed” using a higher concentration of anesthetic, while “local block” generally only use a lower concentration of anesthetic can achieve the therapeutic effect, so there will be no limb dysfunction; in addition, the general “closed” injection drug generally contains only anesthetic, while “local block” use of some direct therapeutic effect on the lesion tissue drugs, such as vitamin B12. 3, the technical difficulty and efficacy of different: “closed “just inject the drug to the proximal end of the pain site or nearby to achieve the purpose, the accuracy requirements are not high, while the “local nerve block” is a long period of professional training senior physicians to properly implement the technical operation, therefore, before treatment must be clearly diagnosed, to find the precise location of the lesion In order to achieve the desired effect of the treatment, it is necessary to accurately inject the treatment drug into the lesion or around the responsible nerve. So the same treatment, no professional training and professional training treatment efficacy is very different. 4, the different requirements for diagnosis: “closed” therapy is based on pain closure to block the pain arc continued, the diagnosis before injection is not necessarily clear, the injection site is not necessarily the lesion, so the diagnosis is not clear can also be carried out, often pain relief but the lesion can still have development. In contrast, before administering “local block” therapy, the diagnosis must be clear and the location of the lesion must be understood, and the drug must be injected into the lesion or the responsible nerve. “Therefore, “local block” is a non-surgical treatment method with fast results, high efficacy, and fewer visits to the hospital by patients. Second, nerve block for pain treatment mechanism 1, sensory nerve block, eliminate the vicious circle of pain. Local pain is transmitted to the spinal cord via sensory nerves, which reflexively causes sympathetic excitation, resulting in vasoconstriction and abnormal tissue hypoxia and metabolism, making the local lesion not easily repaired, and at the same time producing pain-causing substances, making the pain worse and forming a vicious circle. After nerve block, the vicious circle is blocked, local blood circulation is improved, and pain can be significantly reduced. Sometimes the cause of primary pain may have been removed, but the vicious cycle (reflex arc) still remains, nerve block treatment can be blocked once, the pain is cured. 2, muscle relaxation effect: pain is mostly accompanied by muscle protective spasmodic contraction, long-term pain makes the local muscle long-term contracture, stiffness, coupled with vasoconstriction ischemia, and even produce myofasciitis-like changes, blockade treatment can make the pain eliminated, muscle relaxation, blood circulation improved, in a few hours can make the symptoms significantly improved. 3.Improve local circulation: sympathetic nerve block and blocking the vicious cycle caused by pain can increase local blood flow, which can directly treat certain vascular diseases, such as pain caused by diabetic foot or vasculitis. 4.Promote local tissue repair: due to muscle relaxation and improved blood circulation, local injuries are easily repaired, especially in muscle and tendon areas. 5, anti-inflammatory effect: chronic pain is mostly caused by aseptic inflammation, in addition to sympathetic nerve block has an anti-inflammatory effect, a small amount of local corticosteroids, also has a good anti-inflammatory and analgesic effect. 6, psychological factors: chronic pain caused by psychological disorders, emotional instability, irritability, bitterness, aggravating the local pain, block therapy immediately after the pain is eliminated or significantly reduced, mood improvement, increasing the patient’s confidence in the treatment and trust in the doctor. However, many patients do not know much about nerve block therapy and think that the injected drugs contain hormones, which are not good for human body and will cause osteoporosis, etc. Even some physicians may oppose it. In fact, it is far from necessary to be so nervous about nerve block therapy. If we understand its effects, indications and contraindications, we will understand and accept it. For nerve block therapy to achieve the desired effect of treatment, three important components must be passed, namely, correct diagnosis, effective drug composition, and skilled injection technique. Nerve block therapy is arguably the most commonly applied magic bullet for pain physicians and has become the mainstay therapy for pain management. Block therapy is not a temporary pain relief, but a treatment of pain. It is effective for many tendon sheaths, bursae, tendonitis, sacroiliac arthritis, pear-shaped muscle syndrome, tennis elbow, and carpal tunnel syndrome in the shoulder, neck, low back, or extremity areas. For postherpetic pain, trigeminal neuralgia, sciatica, phantom limb pain, burning pain and other refractory neuronal pain, the application of specific nerve block techniques and nerve frequency (thermal) electrical modulation stimulation has achieved satisfactory therapeutic results by blocking nociceptive conduction pathways, improving nerve trophic status and adjusting nerve conduction function. And diagnostic nerve blocks are beneficial to the correct diagnosis or prognosis of pain in many cases. In actual clinical treatment, some diseases are ineffective with conservative treatments such as drugs, and are not suitable or cannot tolerate surgical treatment. The treatment with nerve block method can obtain the effect that cannot be obtained by drug treatment, and it is less damaging, faster and more tolerable for patients than surgical treatment. In other words, nerve block therapy is a treatment measure between drug conservative treatment and surgical treatment.