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Sympathetic Blocks

Sometimes your sympathetic nervous system (SNS) can be involved with causing significant chronic pain. Your sympathetic nervous system (SNS) could be causing you significant chronic pain. Normally your SNS is responsible for your “fight or flight” response. Sometimes it may go into overdrive, which leads to significant pain and dysfunction in many different parts of the body – you arm, leg, abdomen, pelvic region, etc. If you have pain related to your SNS, a sympathetic block may be able to provide prolonged pain relief by numbing up a cluster of these nerves. These injections are typically used in combination with a multimodal regimen that can include physical therapy, medications, and other complementary therapies. The exact location, approach, type of medication(s), dosage of medication(s), is tailored to each individual patient to help ensure your best results.

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Sympathetic Blocks Q&A

Q: What medications will be used?

Depending on the location of your pain and the exact approach of your sympathetic injection, Dr. Zhang will tailor the best and safest formulation and dose for every single patient individually. A local anesthetic is usually injected, sometimes in higher volumes. A local anesthetic is a medication that is often used as a numbing agent by blocking pain signals coming from a cluster of sympathetic nervous system nerves. Sometimes a steroid medication can be added if there are signs of inflammation, and this can prolong your pain relief. A steroid is a medication that can be used to treat many painful conditions by decreasing your body’s inflammatory response.


Q: What is a sympathetic block procedure like?

We will have you come to our state of the art procedural suite for your procedure. We will need to obtain an IV, and may even start some IV fluids as you wait for your procedure. Once in the procedural room, our staff will help position you for your procedure- majority of the time, you will be laying front-side down on your stomach on the X-ray bed. If you are specifically receiving a stellate ganglion block, we will position you laying back with the head of your bed slightly up.  The area will then be cleaned off with some cold soap, which is very important to prevent infection. You will receive some numbing medication that will help prevent pain with the procedure. The doctor will then use fluoroscopy (live X-ray) or ultrasound pictures to guide a needle into the correct space around the sympathetic cluster of nerves. If you do not have any contrast allergies, contrast die is injected We will have you come to our state of the art procedural suite for your procedure. We will need to obtain an IV, and may even start some IV fluids as your wait for your procedure. Once in the procedural room, our staff will help position you for your procedure- typically laying on your stomach on an X-ray bed. Your back will be cleaned off with some cold soap, which is very important to prevent infection. You will receive some numbing medication that will help prevent pain with the procedure. The doctor will then use fluoroscopy, or live X-ray, to guide a needle into the correct space around the sympathetic cluster of nerves. If you do not have any contrast allergies, contrast die is injected to double confirm the needle’s location under fluoroscopic guided procedures only. Once needle placement is confirmed, the medication(s) will be slowly injected. We will then monitor you and go over discharge instructions before letting you leave.


Q: Am I allowed to go back to work on the same day?

Yes, we do allow patients to go back to work. However, we do caution against any heavy lifting or vigorous activity (like running or jumping). One easy rule to keep in mind- if it’s heavier than a carton of milk, don’t lift it!

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