Sympathetic Nerve Block
WHAT IS IT?
A block that is performed to determine if there is damage to the sympathetic nerve chain and if it is the source of pain. This is a diagnostic test primarily, but it may provide relief far in excess of the duration of the anesthetic.
A local skin anesthetic is given in the lumbar or thoracic area of the back. A needle is then inserted into the back under fluoroscopy next to the vertebral body at the block may be performed on both sides of the spine if symptoms are on both sides. An anesthetic medication will be injected into the appropriate ganglion area of suspected pain.
The patient may note redness of the upper or lower extremity and a feeling of warmth.
EXPECTED PROCEDURE TIME
It takes thirty minutes for the procedure followed by evaluation and recovery for several hours.
USUAL COURSE OF TREATMENT
Once the sympathetic chain is identified as the source of pain, medications may be given by mouth to decrease this type of pain. I usually perform repeated injections of the sympathetics to try and shut the pain generation cycle down. If repeat blocks fail, then I perform pulsed or conventional radiofrequency (see below) denervation or sympathectomy of these nerves to permanently shut the pain generation down.
Please click on these links to learn more about the options you have for pain management:
- Radiofrequency Ablation
- Epidural Anesthetic Block And Steroid Injection
- Selective Nerve Root Block (SNRB)
- Facet Block
- Costovertebral Joint Block
- Sympathetic Nerve Block
- Stellate Ganglion Block (Cervical Sympathetic Block)
- Medial Branch Rhizotomy
- Medial Branch Rhizotomy With Pulsed Radiofrequency