The sympathetic nerves run on the front surface of the spinal column. When regulation of the sympathetic nervous system is altered, usually as a result of injury, pain can occur resulting in Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD). A sympathetic nerve block involves injecting numbing medicine around these nerves in the neck or the back, reducing or eliminating the pain.
What is a sympathetic block and why is it helpful?
A sympathetic nerve block involves injecting numbing medicine around the sympathetic nerves in the low back or neck. By doing this, the sympathetic nervous system in that area is temporarily 'switched' off in hopes of reducing or eliminating pain. If pain is substantially improved after the block, then a diagnosis of sympathetically mediated pain is established. The therapeutic effects of the anesthetic can occur, at times, longer than would be normally expected. The goal is to reset the sympathetic tone to a normal state of regulation. If the initial block is successful, then additional blocks may be repeated if the pain continues to sequentially diminish.
What will happen to me during the procedure?
An IV will be started for safety, and so relaxation medicine can be given if needed. After lying on an x-ray table, the skin over the area to be injected will be well cleansed. Next, the physician will numb a small area of skin with numbing medicine (anesthetic) which stings for a few seconds. The physician will use x-ray guidance to direct a needle to the sympathetic plexus of nerves. The physician will then inject contrast dye to confirm that the medicine only goes over the targeted sympathetic nerves. Once this occurs, numbing medicine (anesthetic) will then be slowly injected.