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Sympathetic Nerve Blocks for Pain  

A sympathetic nerve block is believed by many pain healthcare providers to be an effective method for controlling chronic pain. But there is not a great deal of medical evidence to show whether these blocks are actually helpful. This therapy targets the sympathetic nervous system, a series of nerves that spread out from your spine to your body to help control several involuntary body functions, or body functions that you have no control over. These include blood flow, digestion, and sweating.

When can a nerve block be used?

A sympathetic nerve block can be used to diagnose or treat pain involving the nerves of the sympathetic nervous system. Examples of conditions for which a sympathetic nerve block might be used include:

  • Pain from spasms in the blood vessels 

  • Complex regional pain syndrome, previously called reflex sympathetic dystrophy and causalgia

  • Raynaud syndrome

  • Phantom limb pain

  • Some types of chronic stomach pain

  • Excessive sweating

Sympathetic nerve block procedure

The location of your pain usually determines where you’ll receive the nerve block. Your sympathetic nerves come together outside your spine 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 the stellate ganglion in your neck area. If you have pain in the lower part of your body, a ganglion near the lower spine may be targeted with a lumbar sympathetic nerve block.

This is what may happen during a sympathetic nerve block procedure:

  • You will meet with a pain management specialist experienced in conducting nerve blocks.

  • Your specialist will ask about all the medicines you’re taking, including vitamins and supplements, and whether you have any allergies.

  • You may be asked not to eat or drink anything for a specific number of hours before the procedure.

  • Your medical team may start an IV (intravenous) line and monitor your vital signs carefully.

  • You may be given some medicine through the IV line to make you relaxed and sleepy.

  • You will have the area in your neck or back be made numb with a local anesthetic.

  • Your specialist may use X-rays or fluoroscopy to help find the right ganglion.

  • Your specialist will block the ganglion by injecting it with an anesthetic solution, or sometimes other chemicals.

After nerve block treatment

A sympathetic nerve block is a relatively safe procedure. 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 nerve block may include temporary soreness, bleeding, bruising, a feeling of warmth, or some weakness. If you’ve received a nerve block in the stellate ganglion, 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.

Depending on the reason for the block, physical therapy, talk therapy, and pain medicine may all be part of your treatment as well. In most cases, you will be given a series of blocks to get the best possible response.

Sympathetic nerve blocks don’t work for everyone. Also, the pain relief they give may lessen over time. But for some, a sympathetic nerve block may provide weeks or months of pain relief.