Certain nerves run on the front surface of the spinal column. These nerves are involved with many bodily functions that people don’t consciously think about or have direct control over (such as digesting food).
Sometimes a problem with these nerves can contribute to arm or leg pain or pain in the abdomen or pelvis. A sympathetic nerve block involves injecting medication around these nerves. For patients with arm pain, the injection is called a stellate ganglion block.
Patient guidelines (PDF) ›
Procedure overview (PDF) ›
The goal is to provide pain relief so that you are able to resume normal activities. In some cases, we will prescribe a course of physical therapy to help you return to a normal level of activity.
You will be escorted to a room where a nurse will conduct a pre-procedure interview.
The physician who will perform the injection reviews your medical history, previous imaging studies, current medications and physical exam results in order to help plan the best approach for the injection. If you have not had a physical exam prior to the injection, the physician will perform an exam at this time.
You will remain awake during the entire process. Blood pressure, heart rate and breathing are continually monitored.
After you are lying face down on the procedure table, the injection site is cleansed with an antiseptic. This procedure involves inserting a needle through the skin, muscle and soft tissues, so there is some slight discomfort involved.
An injection of local anesthetic (numbing medication) will be administered in the area where you are experiencing pain. The physician then directs a needle with the use of X-ray guidance and deposits the medication.
This procedure takes approximately 30 minutes.
No. Unless your doctor tells you otherwise, you may return
to your usual activities and resume your normal diet immediately after the
Serious bleeding, infection and nerve injury are very rare. The most common side effect is pain at the site of injection; however, you may also experience the following:
- A drop in blood pressure or a change in temperature of the skin on your arm
- A feeling that your eyelid is drooping or your face is flushed
For diabetic patients
If you have diabetes, it is important to know the steroid can cause an elevation in your blood sugar level for up to two weeks after the injection. You should check your blood sugar more often than usual for several days after an epidural steroid injection. If your blood sugar is elevated, please contact the doctor who manages your diabetes for instructions on how to change your diet and/or adjust your diabetes medication.
Yes. You should follow these restrictions after an injection:
- Do not drive for the remainder of the day.
- Do not take a tub bath or soak in water (pool, hot tub) for 24 hours after the injection.
- Allow three days post-procedure before resuming physical therapy.
There are three medications used for the stellate ganglion block:
- Lidocaine or bupivacaine are local anesthetics that are used to numb the area of injection; this numbness usually wears off within two to six hours.
- Lopamidol, an X-ray contrast agent, may be injected into the area to confirm correct placement under the ribs.
- Dexamethasone, a steroid that helps with inflammation and pain, is usually used as well.
You should call your doctor immediately if any of the following occurs:
- Swelling, redness, bleeding or discharge from the site of the injection
- A fever greater than 100˚F
- New or worsening back or neck pain
- New numbness or weakness in your arms or legs
- Chest pain, shortness of breath or persistent cough