Sympathetic Block

 Sympathetic block:

The location of your pain usually determines where you’ll receive the nerve block. Your sympathetic nerves come together outside your spine and pelvis area in thick networks of nerves called ganglions. If you have pain in the upper part of your body, you may get pain relief from blocking a ganglion in the upper thoracic spine.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.

This is what may happen during a sympathetic block procedure:

  • You will meet with a pain management specialist experienced in conducting nerve blocks.
  • Your doctor will ask about all the medications you’re taking, including vitamins and supplements, and whether you have any allergies.
  • You may be asked to fast for about six hours before the procedure.
  • The medical team will start an intravenous line and monitor your vital signs carefully.
  • You may be given some medication through the IV line 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. X-rays (or fluoroscopy) may be used to help the specialist find the right ganglion. Once the ganglion is located, it is blocked by injecting it with an anesthetic solution, or sometimes other chemicals are used.

After nerve block treatment

A sympathetic nerve block is a relatively safe procedure. The procedure usually takes less than 30 minutes and you can usually go home afterward and return to your normal activities after a day of rest. If you had IV 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. If you’ve received a nerve block in upper thoracic spine, 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 medication may all be part of your treatment along with sympathetic block. In most cases, you will be given a series of three to six blocks to get the best possible response.

Although, sympathetic blocks don’t work for everyone, a sympathetic block may provide weeks or months of pain relief.  Sometimes blocks are overactive.

What is a lumbar sympathetic block?

A lumbar sympathetic block is an injection of medication that helps relieve lower back pain, leg pain, neck pain, abdominal pain, or pelvic pain. It can be used to treat:

  • Reflex sympathetic dystrophy
  • Complex regional pain syndrome
  • Herpes zoster infection (shingles) involving the legs
  • Vascular insufficiency
  • Peripheral neuropathy
  • Abdominal pain
  • Chronic pelvic pain
  • Facial pain

Sympathetic nerves are located on both sides throughout your spine, and pelvis. A steroid medication and local anesthetic injected into or around your sympathetic nerves can help reduce pain in that area.


Dr. Spiel’s unique clinical background has enabled him to view the practice of interventional pain through a broader perspective...

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A fellow of the American Academy of Orthopedic Surgery, Dr. Pflum earned his undergraduate degree at Georgetown University, Washington, DC ...

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