by Nicole Berardoni M.D., Tory McJunkin M.D., and Paul Lynch M.D.

Sympathetic-Nervous-SystemSympathetic nerve block is the injection of a local anesthetic into a sympathetic ganglion to diagnose or treat pain disorders that involve the sympathetic nervous system.

The sympathetic nervous system is a linkage of nerves throughout the entire body. The nerves originate in the spinal cord and branch out to influence many bodily functions, such as blood pressure, urination, defecation, and sexual arousal.

A ganglion is a bundle of nerves that come together. The stellate ganglion (upper body) as well as the sympathetic chain (lower body) supply the entire body’s sympathetic nervous system. When these nerves are irritated or injured, the blood supply to your hands, feet, or other areas may be affected and can produce pain or sensory changes. Headaches, neck pain, and facial pain can also be seen in patients who have sympathetic nerve dysfunction.

Procedure

A sympathetic nerve block involves injecting a local numbing anesthetic (lidocaine, bupivacaine) and a corticosteroid into the space where the sympathetic nerve ganglion are located. A local skin anesthetic is given first to numb the area and then another needle is inserted near the ganglion. The entire procedure takes less than 15 minutes and X-ray guidance is used to ensure proper needle position. Sometimes your physician will recommend intravenous sedation to make the procedure more comfortable. Your physician will monitor you after the procedure to see what effects the block has on your pain.

Benefits

Sympathetic-Block-DiagramSympathetic nerve blockade in the cervical and upper thoracic regions are commonly-used techniques for a variety of
diagnostic and therapeutic purposes (Elias 2003). Two things may happen after receiving the block. First, you may
experience complete pain relief. If this happens, your pain is related to your sympathetic nervous system and continued sympathetic nerve blocks will most likely be beneficial. Second, the pain does not go away, but your physician determines that the sympathetic block was physiologically successful. If this happens, your physician may determine that your pain is not originating from the sympathetic nervous system, and the block is of diagnostic value.

Regardless of the outcome, sympathetic nerve blockade is a minimally-invasive treatment that has relieved pain for many people with chronic pain. The most important and greatest success achieved with the use of sympathetic ganglion blocks is the rapid relief of symptoms that allows patients to experience enough relief and regain the ability to resume their normal daily activities and physical therapy.

Risks

With a minimal amount of risks, sympathetic ganglion blocks are considered an appropriate and safe non-surgical treatment for many patients who suffer from pain. Complications of the ganglion block include infection, bleeding, pneumothorax (collapsed lung), nerve damage, and pharmacological complications related to the drugs utilized (Elias 2000).

Since the goal of the procedure is to block sympathetic nerves, some expected but transient changes may result. These changes can include drooping of the eyelid and stuffy nose and usually resolve within hours.

Outcome

Sympathetic nerve blocks are effective in relieving some chronic pain conditions. A difficult to treat condition, complex regional pain syndrome, has been shown to have excellent analgesia and alleviation of clinical pain symptoms after sympathetic blocks.

Pain that originates from the sympathetic nervous system is not easily treated by oral pain medications, so sympathetic blocks are an extremely effective and beneficial treatment option.

If you are suffering from chronic pain and are in need pain relief, call Arizona Pain Specialists today to see what we can do for you.

At Arizona Pain, our goal is to relieve your pain and improve function to increase your quality of life.
Give us a call today at 480-563-6400.

Articles

  • Cervical sympathetic and stellate ganglion blocks. Elias M.Pain Physician. 2000 Jul;3(3):294-304
  • Sympathetic nerve blocks in mandibular herpes zoster and postherpetic neuralgia.
    Gomes RT, de Nazareth Pedras RB, da Silva JF, de Aguiar MC.Headache. 2007 May;47(5):728-30
  • Stellate ganglion blockade provides relief from menopausal hot flashes: a case report series. Lipov E, Lipov S, Stark JT. Womens Health (Larchmt). 2005 Oct;14(8):737-41