Sympathetic Nerve Block (Cervical | Lumbar)

What is a Sympathetic Nerve Block?

A sympathetic nerve block is a minimally invasive injection used to interrupt the sympathetic nervous system’s contribution to pain involved in Complex Regional Pain Syndrome. It involves injecting a local anesthetic—sometimes with a steroid—near a sympathetic ganglion (a group of nerve cell bodies) to temporarily block sympathetic nerve signals.

What are the benefits of a Sympathetic Nerve Block?

The sympathetic nervous system regulates involuntary functions like blood flow and sweating, and in certain pain conditions—especially neuropathic or regional pain syndromes—this system becomes overactive and contributes to persistent, poorly localized pain, color/temperature changes, and swelling.

How does a Sympathetic Nerve Block work?

A sympathetic nerve block works by interrupting abnormal pain signals transmitted through the sympathetic nervous system, which controls involuntary body functions like blood flow, sweating, and skin temperature. In certain pain syndromes, this system becomes overactive and contributes to persistent or exaggerated pain—even after an injury has healed. The injection is intended to target the specific area of overactivity that corresponds with the painful condition—upper or lower extremity, abdomen, pelvis, tailbone, etc.

How to prepare for a Sympathetic Nerve Block?

The first step to determine your eligibility to receive a sympathetic nerve block is to perform a thorough physical examination and carefully consider your medical and family history. This step is particularly crucial as steroids may temporarily elevate blood sugar levels in people with diabetes and affect patients with bleeding problems.

-Blood thinners (e.g., aspirin, Plavix, Eliquis, warfarin):
You will need to stop them before the procedure to reduce bleeding risk. Only do this under medical supervision.
-Diabetes
Steroids can temporarily raise blood sugar levels. Adjustments may be needed.
– Medical Clearance (if needed)
If you have heart conditions, bleeding disorders, or infections, your provider may require clearance from your primary doctor or specialist.

What to expect after the procedure?

A sympathetic nerve block is usually performed in under 20 minutes with the patient’s ability to go home the same day after a short recovery period. If anesthetic medicine was used, the patient may have numbness immediately after the injection but will dissipate in a matter of hours. We do not recommend that you drive or do any strenuous activity for the first 24 hours after the procedure. Patients who have this type of procedure often experience early relief, but this is typically the result of the anesthetics. Once this wears off, it can take 2 to 3 days for the steroids to take effect and provide long-term relief.