Sympathetic Nerve Block

A sympathetic nerve block is an injection used to relieve pain caused by problems with the sympathetic nervous system — a network of nerves that controls involuntary functions like blood flow, sweating, and pain signaling.

The procedure involves injecting a local anesthetic (sometimes combined with medication) around a group of sympathetic nerves. By temporarily “turning off” these nerves, the block can:

  • Reduce pain
  • Improve circulation
  • Help determine if the sympathetic nervous system is a source of your pain

Who Benefits from a Sympathetic Nerve Block

    At iSpine Clinics, a sympathetic nerve block may be recommended if you have:

    • Complex Regional Pain Syndrome (CRPS) in the legs or feet

    What to Expect

    • Preparation: You may be asked not to eat or drink for a few hours before the procedure. Arrange for someone to drive you home.
    • Positioning: You’ll lie on your back or stomach, depending on the nerve group being targeted.
    • Anesthesia: The skin over the injection site will be cleaned and numbed with local anesthetic.
    • Imaging Guidance: Fluoroscopy (X-ray) or ultrasound is used to guide the needle safely to the medial branch nerves.
    • Injection: After numbing the skin, a thin needle is placed near the target nerve, and contrast dye is injected to ensure the medicine reaches the desired area. Then, a small amount of local anesthetic (and sometimes a steroid) is injected.
    • Duration: The procedure usually takes under 30 minutes.
    • Outpatient: Patients go home the same day.

    After the Procedure

      • Immediate Effects:
        • A feeling of warmth in the treated area
        • Reduced pain in the affected region
        • Possible temporary weakness or numbness
      • Pain Relief: Some patients experience pain relief right away, while others may need a series of blocks for maximum benefit.
      • Temporary Side Effects:
        • Mild bruising or soreness at the injection site
        • Lightheadedness or low blood pressure
        • Temporary changes in sensation or muscle control
          These usually resolve within a few hours.

      Recovery and Aftercare

        • Activity: Rest on the day of the procedure; you can usually resume normal activities the next day.
        • Monitoring: Track your pain levels and functional improvements — this helps determine if the block was successful.
        • Repeat Treatments: Some patients may need multiple injections for longer-lasting relief.
        • Comprehensive Care: Often combined with physical therapy, medications, or other treatments to maximize recovery and mobility.

        Risks and Considerations

        While generally safe, sympathetic nerve blocks carry some risks, including:

        • Temporary soreness or bruising at the injection site
        • Bleeding or infection (rare)
        • Allergic reaction to medication
        • Nerve injury (very rare)
        • Low blood pressure or dizziness
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