Sympathetic Nerve Blocks
Part of the autonomic nervous system, the sympathetic nerves tell the body to perform basic living functions. The sympathetic nerves branch off of the spine and control blood flow, body temperature, sweating, heart rate, and other bodily functions. Sympathetic nerves also have the ability to carry pain signals to and from the brain, causing the patient to feel pain. During a sympathetic nerve block, a physician injects numbing medicine and potentially a steroid around the sympathetic nerves. Medication eliminates the signals from the nerves which eliminates the pain signals back to the brain, in turn eliminating the pain that the patient feels. Do not confuse with epidural steroid injections.
Candidates for Sympathetic Nerve Blocks
Sympathetic Nerves blocks help alleviate pain and also aid in diagnosing the source of the pain. A sympathetic nerve block may help those experiencing:
- Chronic pain
- Pain from blood vessels
- Complex Regional Pain Syndrome
- Raynaud’s Syndrome
The Process of sympathetic nerve blocks
The patient receives an IV with relaxing medication if needed. While the patient lays on their stomach with their back exposes, the physician cleans the area where the injection takes place with an antibacterial solution. The physician injects a numbing medication to numb the area in preparation for the deeper injection. Once the rehabilitation physician adequately numbs the area, X-Ray guidance called fluoroscope allows the doctors to administer the injection in live time to ensure the injection covers the correct nerves. The physician injects contrast dye to confirm that the medication effects the correct nerves. Once confirmed, the physician injects anesthetic. The anesthetic blocks the nerve signal which in turn stops the patient from processing the pain. The patient must have someone drive them home from the hospital and should relax the remainder of the day.
What to expect after a sympathetic nerve block
Following the procedure, the patient relaxes for roughly 30 minutes. After 30 minutes, the patient moves around to try to instigate the typical pain. The patient’s pain may not improve immediately and should reevaluate the pain levels for the next 24 hours. If pain remains, the sympathetic nerves did not carry the pain signals.
Potential Risks and complications of sympathetic nerve blocks
Like any procedure, a sympathetic nerve block has potential risks and complications. If injecting the sympathetic nerves in the neck, the eyelid may droop and show redness for a few hours following the procedure. Pain levels may increase temporarily following the procedure when the numbing medication starts to wear off. Doctors recommend using ice to control this pain rather than heat for the first few days following a sympathetic nerve block. They may also reccomend a physical therapy regimen.