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Sympathetic Block

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 in the back. Depending on the area of your pain, the injection may have a different specific name.

Patient guidelines (PDF) ›

Procedure overview (PDF) ›

What is the goal of a sympathetic block?

The goal is to provide pain relief so that you are able to resume normal activities. In many cases, we will prescribe a course of physical therapy to help you return to a normal level of activity.

What happens before treatment?

You will be escorted to a room where a nurse will conduct a pre-procedure interview. The physician who will perform the injection will conduct a physical exam, review your medical history, previous imaging studies and current medications to help plan the best approach for the injection

What happens during the procedure?

You will remain awake during the entire process while your blood pressure, heart rate and breathing are continually monitored.

While 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.

Should I limit my activity or change my diet after the injection?

No. Unless your doctor tells you otherwise, you may return to your usual activities and resume your normal diet immediately after the injection.

Are there any side effects caused by a sympathetic block?

  • For diabetic patients: It is important for you to know that if you have diabetes, the steroid can cause elevation in your blood sugar level for up to two weeks after the injection. If you have diabetes and regularly check your own blood sugar, you should check your blood sugar more often during the first several days after an epidural steroid injection. Please talk with the doctor who helps to manage your diabetes for instructions in how to change your diet and/or diabetes medication if your blood sugar is elevated.
  • The most common side effect is pain at the site of injection.
  • The back or legs may feel weak or numb for a few hours after the procedure. This is not an emergency.
  • Serious bleeding or infections following the procedure are very rare. Serious nerve injury is extremely rare.
  • You may feel a drop in blood pressure or a change in temperature of the skin on the leg.
  • You may experience an increase in bowel movements.

Are there any restrictions after a sympathetic block?

Yes. You should follow these restrictions:
  • Do not drive for the remainder of the day
  • Do not take a tub bath or soak in water (i.e. pool, hot tub) for 24 hours after the procedure
  • Allow three days post-procedure before resuming physical therapy

What are the medications used for a sympathetic block?

  • Lidocaine or bupivacaine are local anesthetics which 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, or another steroid that helps with inflammation and pain, is usually used, as well

When should I call my doctor?

You should call us immediately if any of the following occur:

  • If you experience any swelling, redness, bleeding or discharge from the site of the injection
  • If you have a fever greater than 100 degrees Fahrenheit
  • If you experience new or worsening back or neck pain
  • If you experience a new numbness or weakness in your arms or legs
  • If you experience any chest pain or shortness of breath or persistent cough

To be seen by one of our specialists, call 949-UCI-PAIN (949-824-7246) or request an appointment online ›

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To reach a doctor or nurse during business hours (Monday through Friday, 8 a.m. to 4 p.m.), call 949-824-7246 and leave a message. Your call will be returned within 12 business hours.

After business hours or on weekends: call the main hospital at 714-456-7890 and ask the hospital operator to contact the doctor on call by paging 3386.