Sympathetic Nerve Blocks

If you have a history of chronic pain related to the sympathetic nervous system (also known as sympathetically mediated pain), a sympathetic nerve block may be recommended to manage your pain.

Chronic pain is often influenced by hormones in the body—specifically, epinephrine and norepinephrine. Sympathetic nerve blocks temporarily reduce these hormones in the pained areas, which can result in pain relief. If repeated, this procedure can likely lead to long-term pain relief.

To find out if a sympathetic nerve block may help you, call us today at (480) 573-0130

or contact us online.

What Are Sympathetic Nerve Blocks Used For?

The sympathetic nervous system affects involuntary bodily functions, which you have no conscious control over. Examples of involuntary bodily systems include breathing, blood vessels, digestion, and sweating. Chronic pain related to these systems can result in several diagnoses, including:

• Complex regional pain syndrome
• Peripheral neuropathy
• Phantom limb pain
• Angina
• Peripheral vascular disease
• Raynaud’s phenomenon
• Excessive sweating
• Post-herpetic neuralgia
• Abdominal or intestinal pain
• Pelvic or rectal pain
• Tailbone pain
• Pain related to certain cancers

The location of the nerve pain determines where you will receive the nerve block.

Depending on the specific area being targeted, sympathetic nerve blocks typically involve the following nerve bundles:

• Stellate ganglion (affecting the upper body)
• Lumbar sympathetic (affecting the lower body)
• Splanchnic nerve
• Celiac plexus
• Hypogastric plexus
• Ganglion impar

What Happens During a Sympathetic Nerve Block?

The first step in receiving a sympathetic nerve block is meeting with a board-certified pain specialist trained to perform the procedure. He or she can help determine the best approach to addressing your pain and discuss sympathetic nerve blocks in detail.

To prepare for your procedure, you may be asked to fast before your appointment. Once there, you may be given intravenous (IV) medication to help you relax and a local anesthetic at the injection site.

Usually, a combination of a steroid and numbing medication is injected into the sympathetic nerve bundle area. The injections are guided to the correct location using x-ray (fluoroscopic) or ultrasound guidance. Once the injection is completed properly, you may experience increased temperature and skin color changes.

What Happens After a Sympathetic Nerve Block?

Sympathetic nerve blocks are generally considered a low-risk procedure. You will be observed briefly after the injection before being allowed to return home. If you received sedation, someone will need to drive you home. Your provider will instruct you on rest and activity levels after the sympathetic nerve block procedure, but most people can return to normal activity the next day.

If a patient experiences a specific percentage of pain relief after a sympathetic nerve block, it likely means the source of the nerve pain has been correctly identified and treated.

Sympathetic Nerve Block FAQs

Before opting for this procedure, some common questions include:

What are some risks of a sympathetic nerve block?

After a sympathetic nerve block, some swelling, bruising, or soreness at the injection site is common. Less frequently, bleeding, headache, dizziness, or numbness may occur. Rarely, sympathetic nerve blocks can lead to infection, allergic reaction to the medication used, injection into a blood vessel or lymph node, nerve damage, or injury to a kidney or ureter.

How long does it take for a sympathetic nerve block to work?

The local anesthetic in the procedure numbs the area immediately, so you may have some pain relief as soon as the procedure is done. This may decrease as the anesthetic wears off quickly. However, the steroid used can take a few days to take full effect but will also help to further relieve pain.

How long does a sympathetic nerve block last?

There are differences in how each person responds to a sympathetic nerve block, but patients can expect pain relief to last anywhere from 1-4 weeks or possibly even longer1.

What happens when a sympathetic nerve block doesn’t last?

Sympathetic nerve blocks are often repeated in cases where the pain relief is short-lived. Sometimes multiple injections, even over the course of a year, can help with lasting pain relief.

Along with frequent injections, physical therapy and pain medications may also be recommended to help with pain.

Radiofrequency procedures may be performed for longer-lasting effects.

Ready to Learn More About Sympathetic Nerve Blocks?

If you’re living with chronic pain due to sympathetically mediated pain, a sympathetic nerve block may offer relief. The specialists at Advanced Spine and Pain can evaluate your concerns and help you understand and plan the best course of treatment.

Contact us today for expert advice from our team or call us at (480) 573-0130.

References:

1. Cheng, J., Salmasi, V., You, J., Grille, M., Yang, D., Mascha, E. J., Cheng, O. T., Zhao, F., & Rosenquist, R. W. (2019). Outcomes of Sympathetic Blocks in the Management of Complex Regional Pain Syndrome. Anesthesiology, 131(4), 883–893. https://doi.org/10.1097/aln.0000000000002899