Cervical and Lumbar Sympathetic Blocks

What are the sympathetic nerves?

The sympathetic nerves are a chain of nerves that run on the front side of the spinal column. They are part of the autonomic nervous system which controls many bodily functions we don't think about, such as sweating, heart rate, digestion, and blood pressure.

For unknown reasons, the sympathetic nervous system can become activated and transmit pain following an injury, be it minor or major. This can result in a condition known as Chronic Regional Pain Syndrome (CRPS)-formerly known as Reflex Sympathetic Dystrophy (RSD). Symptoms of CRPS include severe burning pain, swelling, and skin color changes.

What is a sympathetic block? Why is it helpful?

A sympathetic block involves injecting local anesthetic around the sympathetic nerves in the neck or low back. The Stellate Ganglion is a grouping of sympathetic nerves in the neck. A Stellate Ganglion Block is useful for arm, shoulder or facial pain. For back, leg, or foot pain the sympathetic nerves in the low back are targeted. This is called a Lumbar Sympathetic Block.

The purpose of these injections is to confirm the diagnosis of CRPS and to calm down the sympathetic nerves. Depending on the severity of the condition, a series of injections may be required.

What will happen to me during the procedure?

An IV will be started so that relaxation medication can be given. You will be taken to a procedure room and positioned on an x-ray table. Monitors will be placed on you to watch your heart rate, blood pressure, and blood oxygen level.

After your skin is washed with a sterile scrub, x-ray images of your back will be taken. Small marks may be placed on your skin using a sterile pen. Next the skin is numbed with local anesthetic medication. Your physician will use fluoroscopy (x ray) to assure correct placement of the needle near the sympathetic nerves. A small amount of x-ray dye is then injected to confirm proper spread of medication. A local anesthetic (numbing) medication is then injected.

What will happen after the procedure?

You will then be taken to the recovery area and monitored for 30-60 minutes. Discharge instructions will be given to you before leaving the surgical center. You will be asked to keep track of the amount of pain relief, area of pain relief, and duration of pain relief.

You will require a driver to take you home because sedation is given during the procedure.

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