Nerve Blocks

Nerve blocks are injections of local anesthesia around the sympathetic nerves in the neck or lower back. The sympathetic nerves are present on the front side of the spinal column. This chain of nerves is part of the autonomic nervous system and controls such bodily functions as sweating, heart rate, digestion, and blood pressure. In some cases following an injury, the sympathetic nervous system becomes activated. This can result in the condition known as Complex Regional Pain Syndrome (CRPS), formerly called Reflex Sympathetic Dystrophy (RSD). Symptoms of CRPS include severe burning pain, swelling, and skin color changes in an upper or lower extremity following an injury. The nerve block procedure blocks can be used at the Stellate Ganglion, a grouping of sympathetic nerves in the neck. This type of block is helpful for pain in the arm, shoulder, or facial area. A Lumbar Sympathetic Block is helpful for back, leg, or foot pain. These nerve blocks not only help to ease the painful symptoms of CRPS, they also confirm the diagnosis. A series of nerve block injections may be required depending upon the severity of the condition.

The nerve block procedure is performed under local anesthesia with IV sedation. The physician uses fluoroscopy or x-rays to determine the correct placement of a needle placed near the sympathetic nerves. A small amount of x-ray dye is injected to confirm proper spread of medication. A local anesthetic (numbing) medication is then injected through the needle. Following the block, the patient may be asked to move into a position that normally produces his or her pain. It is not uncommon for patients to have some weakness and numbness of their arms, chest wall, or legs for a short while after the procedure. This is more common after a selective nerve block. Patients may be asked to keep a record of their pain relief during the next several days or longer. Patients should consult their physician for a complete explanation of the procedure and its associated risks and complications.

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