Sympathetic Nerve Blocks (Lumbar, Stellate)

The Lumbar Sympathetic Nerve Block is a procedure used to block or decrease pain in the lower extremities caused by injury or disease of the sympathetic nervous system. The lumbar sympathetic nerves are located on either side of the lumbar spine (lower back).

After an injury or illness, the sympathetic nervous system may not function properly, causing pain. Some of the more common conditions include Complex Regional Pain Syndrome also known as Reflex Sympathetic Dystrophy, Sympathetic Maintained Pain and Herpes Zoster (shingles) involving the lower part of the body.

If the block relieves your pain, the doctor will then perform a series of blocks at a another time, in an attempt to break the pain cycle and provide long lasting pain relief. The number of blocks you will need depends on how long the pain relief lasted between injections. Usually you will get more and longer pain relief after each injection. If the series of blocks do not relieve your pain, a radiofrequency lesion may be done, or consideration of stimulator implant may be necessary.

A Stellate Ganglion Block is the injection of a small amount of local anesthetic and steroid near a group of nerves in the neck area. The stellate ganglion is made up of the fused portion of the seventh cervical and first thoracic sympathetic ganglia.

A stellate ganglion block may be performed if you are experiencing facial pain, neck pain, or arm pain as a result of the following: shingles affecting the trigeminal nerve or cervical and upper thoracic dermatomes; acute vascular insufficiency of the face and arms; chronic regional pain syndrome of the face, neck, arms, and upper thorax; Raynaud’s syndrome of the arms; phantom limb pain; and sympathetically mediated pain from cancer.

A Stellate Ganglion Block procedure usually takes approximately 5-10 minutes to complete. This Stellate Ganglion Block procedure does come with risks. Complications that can occur include but are not limited to local anesthetic toxicity, bruising, hematoma formation, injection of local anesthetic into the epidural, subdural, and subarachnoid spaces, total spinal anesthesia, pneumothorax, Horner’s syndrome causing drooping of the eyelid, block of the recurrent laryngeal nerve causing hoarseness and difficulty swallowing, infection, and reaction to the steroid medication.

A stellate ganglion block will NOT be performed if you have an active infection, fever, bleeding problems, allergy to the local anesthetic and steroid, and/or pregnancy.

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