The sympathetic nervous system is responsible for regulating our heart rate, breathing and other bodily functions that are not usually under our conscious control. It is comprised of preganglionic neurons that originate at the thoracic or lumbar spinal regions and travel to a group of nerve cell bodies called a ganglion, where they pass their signals to a second group of neurons call postganglionic neurons which in turn travel to its peripheral target tissues or organ for regulatory functioning. Sometimes this nervous system malfunctions and causes a burning pain in either the arm or leg.
A sympathetic block is used to alleviate this type of pain. The injection is done to block the Sympathetic Nerves that travel along the side of the spine. In the cervical region, Stellate Ganglion block is preformed and in the lumbar region the lumbar sympathetic block can be done to reduce sympathetic mediated pain, swelling, color, and sweating changes in the extremity (arm or leg) that may improve mobility. Examples may include; Complex Regional Pain Syndrome, Reflex Sympathetic Dystrophy (RSD), Sympathetically Mediated Pain, Raynaud’s Syndrome, Vascular Insufficiency pain, and Herpes Zoster (shingles).
Stellate Ganglion Block is an injection of local anesthetic into the stellate ganglion located at the base of the neck. This injection is for sympathetically mediated conditions in the face and arm.
Lumbar Sympathetic Block is performed for pain in the lower extremity. The lumbar sympathetic plexus is a group of nerves that are responsible for sympathetically mediated pain in the leg.
Celiac Plexus refers to a large area of nerves in the abdomen that travel to the pancreas, liver, gall bladder, stomach, and intestine. Other examples of sympathetic nerve tissues are the hypogastric plexus and ganglion of impar. If the diagnostic sympathetic blocks are effective at controlling the pain there are advanced procedures that are effective for providing long term relief such radiofrequency lesioning or spinal cord stimulation.
This procedure is a safe procedure that is minimally invasive. However, with any procedure there are risks, side effects, and possibility of complications. These risks are minimized by using sterile technique and accuracy with use of XR (fluoroscopy) throughout the procedure. The most common side effect is pain at the injection site which is temporary. The other potential, but rare risks involve bleeding, infection, spinal block, epidural block, and injection into blood vessels and surrounding organs. Fortunately, the serious side effects and complications are uncommon.