A sympathetic nerve block can be an effective method for controlling certain types of chronic pain. This therapy targets the sympathetic nervous system, a series of nerves that spread out from your spine to your body to help control several involuntary body functions, or body functions that you have no control over. These include blood flow, digestion, and sweating. Depending on where your pain is located, this type of injection can diagnose and treat pain that involves the nerve of the sympathetic nervous system.

What types of sympathetic nerve blocks are there?

Depending on where your pain is located, your physician may recommend one of three different injections.

  • If your pain is located in the arm or hands, then your physician may recommend a stellate ganglion block.
  • If your pain is located in your abdomen, then your physician may recommend a celiac plexus block.
  • If your pain is located in your legs or feet, then your physician may recommend a lumbar sympathetic block.

When can a nerve block be used?
Examples of conditions for which a sympathetic nerve block might be used include:

  • Pain from spasms in the blood vessels
  • Pain from internal organs (i.e. pancreas, colon)
  • Complex regional pain syndrome, previously called reflex sympathetic dystrophy and causalgia
  • Raynaud’s syndrome
  • Some types of chronic stomach pain
  • Excessive sweating
  • Post traumatic stress disorder
  • Pelvic pain

Sympathetic nerve block procedure
This is what may happen during a sympathetic block procedure:

  • You will meet with a pain management specialist experienced in conducting nerve blocks.
  • Your health care provider will ask about all the medicines you’re taking, including vitamins, supplements, blood thinners, over-the-counter medications, and whether you have any allergies.
  • If you are felt to be appropriate for the procedure then they will schedule an appointment. Blood thinners will likely need to be stopped before the procedure, and details should be discussed with your physician.
  • You may be asked to fast for about 8 hours before the procedure.
  • The medical team may start an intravenous line and monitor your vital signs carefully.
  • You may be given some medicine either orally or via IV to make you relaxed and sleepy.
  • Before the actual block, the area in your neck or back will be made numb with a local anesthetic.
  • Fluoroscopy (or X-ray) or Ultrasound may be used to help the specialist find the right location.
  • Once the ganglion is located, it is blocked by injecting it with an anesthetic solution and sometimes a steroid.

After nerve block treatment
A sympathetic nerve block is a relatively safe procedure. You can usually go home afterward and return to your normal activities after a day of rest. If you had sedation, you’ll need to have someone drive you home.

Side effects after a sympathetic block may include temporary soreness, a feeling of warmth, or some weakness in the legs or arms. If you’ve received a nerve block in the stellate ganglion, you may experience some temporary voice changes, eyelid droop, or difficulty swallowing. Until swallowing is back to normal, avoid large bites of food and sip liquids carefully.

Physical therapy, talk therapy, and pain medicine may all be part of your treatment along with sympathetic block. In most cases, you will be given a series of blocks to get the best possible response.

Sympathetic blocks don’t work for everyone. Also, the pain relief they give may lessen over time. But for some, a sympathetic block may provide weeks or months of pain relief.

*Information on this page was modified from John Hopkins