Sympathetic Nerve Blocks: Cervical and Lumbar Procedures for Pain Management

What are Sympathetic Nerves?

The sympathetic nervous system is a crucial part of the autonomic nervous system, which controls various involuntary bodily functions. These include:

• Blood flow to the extremities
• Sweating
• Heart rate
• Digestion
• Blood pressure
• Goosebumps
• And many other automatic processes

Essentially, the sympathetic nervous system manages functions that you don’t consciously control. It plays a vital role in your body’s “fight or flight” response and helps regulate your body’s reaction to stress and environmental changes. When this system malfunctions and causes pain or other symptoms, targeted treatments like sympathetic nerve blocks can help provide pain relief and restore normal function.

Why Sympathetic Nerve Blocks Are Helpful?

Sometimes, arm or leg pain can be caused by a malfunction of the sympathetic nervous system, often following an injury. In these cases, a sympathetic nerve block can be an effective treatment option.

Sympathetic nerve blocks can help with conditions such as:

• Complex Regional Pain Syndrome (CRPS)
• Reflex Sympathetic Dystrophy (RSD)
• Anosmia (lack of smell) and Dysgeusia (altered taste) due to COVID

By temporarily blocking the function of these nerves, we aim to reduce or eliminate pain. If the initial block provides temporary relief, additional blocks can be administered every 7-10 days to achieve more lasting pain relief and functional improvement.

Types of Sympathetic Nerve Blocks

Cervical (Stellate Ganglion) Block

• Targets the sympathetic nerves in the neck area
• Helps treat pain in the head, neck, upper chest, shoulders and arms

Lumbar Sympathetic Block

• Focuses on the sympathetic nerves in the lower back
• Treats pain in the lower back, hips and legs

The Procedure Explained

Before the Procedure

• Fast for six hours prior to the appointment 
• You may have sips of clear liquids until two hours prior to the appointment
• Continue taking routine medications unless instructed otherwise
• If you are taking a blood thinner, please notify the office immediately
• Wear loose, comfortable clothing
• Arrange for a responsible adult to drive you home
  

During the Procedure

• You’ll lie on an x-ray table — on your back for a cervical block, or on your side for a lumbar block
• The area will be cleaned with sterile soap and draped
• Using a fluoroscopic (x-ray) guided injection, the physician will locate the target area
• A small area of skin will be numbed with local anesthetic
• A small needle will be directed toward the sympathetic nerves
• A small amount of contrast dye will be injected to ensure proper needle position
• Anesthetic medication will be injected around the nerves

The entire procedure typically takes about 30-45 minutes.

After the Procedure

• You’ll be monitored in a recovery area for about 15 minutes
• For cervical blocks, you may experience temporary side effects which are signs that the injection is working, such as:
  • Hoarseness
  • Feeling of a lump in the throat
  • Redness of the eye
  • Drooping of the eyelid
  • Nasal stuffiness
  • Pupillary constriction
• For both types of blocks, you may notice increased warmth and redness in the affected limb
• You will not be able to drive on the day of the procedure
• You can usually return to normal activities the following day

Finding A Provider For Sympathetic Nerve Blocks

Sympathetic nerve blocks can be an effective treatment for chronic pain issues. If you’re experiencing persistent pain in your arms or legs, especially due to RSD or CRPS that hasn’t responded to other treatments, a sympathetic nerve block might be a beneficial option for you.

We encourage you to consult with one of our experienced Physical Medicine and Rehabilitation physicians at Desert Spine and Sports Physicians to determine if this procedure is right for you. Our team is committed to providing comprehensive, personalized care to help you find relief from your pain.

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