Sympathetic blocks treat pain related to Chronic Regional Pain Syndrome (CRPS), pelvic pain, chronic abdominal pain, post surgical pain and cancer related pain.

When the pain experienced by an individual stems from sympathetic nervous system, a lumbar sympathetic block can be performed. Using an X-ray machine, a small needle is advanced towards the nerves that are damaged.  A local anesthetic and a steroid is injected around the nerves, which interrupts the pain pathway. The procedure is designed to be both diagnostic and therapeutic, and typically offers immediate pain relief to the patient.

You will be monitored in the recovery room for 30 minutes. Most of the time the pain reduction occurs within minutes. This is typically accompanied by increased temperature of the affected extremity. The anesthetic medication which causes pain relief will typically stop working in a few hours and the steroid medication will start working in a few days. Thus, while the pain reduction is typically immediate we encourage our patients to wait a full week for full results.

The results are variable and will depend on the severity of the condition.  For some patients this treatment provides long lasting pain relief.  For other, the effects can last a few weeks to months, and the procedure may need to be repeated.  For patients suffering from CRPS or chronic pelvic pain, we offer this treatment up to 4 times a year if needed.

The procedure is done with the assistance of anesthesiologist to provide you with a painless experience.  An IV is placed and a mild sedative is injected. You do not need to be completely asleep, but comfortably sedated.  The patient is positioned on the table face down.  Using a live X ray machine, a small needle is inserted through the back towards the sympathetic chain. Once in place, a local anesthetic and a steroid is injected through the needle to effectively block pain transmission from those nerves.

A sympathetic nerve block injection involves injecting a local numbing anesthetic (Lidocaine, Bupivacaine) and a corticosteroid into a space where the sympathetic nerve roots are located. The location of your pain usually determines where you’ll receive the nerve block. The sympathetic nerves come together outside the spine in a networks of nerves called the sympathetic chain. If you’re experiencing pain in the upper part of your body, you may get pain relief from blocking the stellate ganglion or sympathetic chain in your neck area. If you have pain in the lower part of your body, a ganglion near the lower spine may be targeted with a lumbar sympathetic block.

A local skin anesthetic is injected to numb the skin.  A needle will be inserted near the ganglion or sympathetic chain under X-ray guidance (fluoroscopy).  Once proper positioning is confirmed, local anesthetic and steroid is injected around the sympathetic chain. This procedure takes less than 15 minutes. You will be offered intravenous sedation to make the procedure more comfortable.  It is generally not painful and very well tolerated.