Sympathetic block injections, also called sympathetic nerve blocks, are injections of medications (for example, steroids) around sympathetic nerve roots along the spine to provide temporary relief from chronic pain.
These injections are administered into the ganglions, nerve bundles that control the sympathetic nervous system. Ganglions are located along the spine, at the end of each spinal nerve, and extend throughout the body and control involuntary body functions like digestion. The location of the sympathetic nerve block injection will be determined by where the individual’s pain is located. Sometimes, sympathetic block injections are administered as a series of injections to provide long-term pain relief.
Why a sympathetic block is performed
Sympathetic nerve block injections are used to treat pain associated with the sympathetic nervous system, including:
- Vascular pain: Pain that develops when there is a lack of blood flow to tissues or an organ
- Visceral pain: Pain in the organs and structures of the thorax, or the trunk of the body
- Neuropathic pain: Pain that is characterized by a burning or shooting sensation
What to expect during a sympathetic block procedure
A sympathetic nerve block procedure takes approximately 30 minutes to complete. Before the procedure, the patient is given a sedative via an IV to help them relax. Next, the patient is asked to lie face down on an x-ray table so that the pain specialist can access the injection area. During the procedure, x-ray images are used to guide the pain specialist to ensure proper placement of the injection. A topical anesthetic is applied to the area, the area is cleaned, and the injection is administered.
Risks associated with sympathetic blocks
Risks associated with sympathetic nerve blocks include:
- Pain and/or swelling in the area of the injection
- Bleeding at the injection site
Some patients may experience short-term side effects, such as:
- Tenderness in the area of the injection
- Warmth in the area of the injection
Side effects generally subside after a few days.
Benefits of a sympathetic block
Sympathetic nerve block injections help patients control chronic pain and restore mobility to areas of the body that have suffered decreased mobility due to pain. Sympathetic block injections provide a localized pain treatment without an invasive surgical procedure. They may also be used in pain diagnosis.
How to prepare for a sympathetic block procedure
When meeting with a pain specialist, it’s important that patients discuss all medications they are currently taking. Patients may be instructed to discontinue certain medications, like blood thinners, for a few days before a sympathetic block to lower the risk of bleeding. Additionally, patients may be asked to refrain from eating and drinking for at least six hours before the procedure. It’s important to follow all pre-procedure instructions given by the medical team to avoid possible complications.
Post sympathetic block treatment
Patients are able to go home the same day of the procedure. However, they will be directed to not drive or partake in vigorous activities for 24 hours.
Doctors may recommend physical therapy for some patients while they are pain-free to increase mobility in the area. Pain relief can last for several weeks to up to several months and varies from person to person.
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