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Sympathetic Nerve Block Treatment in NYC

Some lower back pain can be successfully treated with a lumbar sympathetic nerve block. Administered by an experienced NYC pain management doctor, this treatment comprises a series of injections to block the pain from reaching your brain. Similarly, a stellate gang block, or stellate ganglion block, accomplishes the same thing, but in your upper body instead of in your lower back. Make an appointment today with the best-rated pain relief specialist Dr. Melepura of the sports injury clinic of NYC.

Sympathetic Nerve Block in NYCAn effective treatment to ease pain in your lower back, a lumbar sympathetic nerve block delivers pain relief exactly where it’s needed. A sympathetic block is a series of injections aimed at stopping your sympathetic nerves from carrying pain massages from your lumbar or lower back up to your brain. It’s considered a pain management technique.

Your sympathetic nerves don’t always carry pain massages, and they don’t hurt just because another set of nerves are hurting. Your lumbar sympathetic nerves run along your spine in your lower back. Most of the time, their purpose is to control your body’s unconscious functions, like your breathing and blood flow.

Why You Need a Sympathetic Block

A lumbar sympathetic nerve block delivers anti-inflammatory pain medicine directly to your sympathetic nerves, where you’re feeling the pain. In most cases, the pain from your sympathetic nerves travels from your lower back down one leg. Since sciatica presents similar symptoms, it takes a knowledgeable and experienced pain physician in New York City to diagnose the real cause of your pain.

The pain you experience can affect your day-to-day life and your activity levels. The discomfort isn’t limited to an activity like running or standing either; it’s a constant ache that can force you to seek over-the-counter pain relievers. The pain may limit your mobility as well. If rest and nonprescription medications don’t ease your pain, schedule a visit to the Sports and Pain Institute of Manhattan, NY.

Sympathetic nerves run along both sides of your spine. If you feel pain in your face and upper body, a stellate gang block may help. Like a lumbar sympathetic nerve block, a stellate gang block eases pain, but instead of pain in your lower back and leg, this pain is in your head, chest or arms. This procedure may also be used as a diagnostic tool to test whether your stellate ganglion is the cause of your pain and discomfort.

The Sympathetic Block Procedure

Both a lumbar sympathetic nerve block and a stellate gang block are painless. They’re outpatient procedures that can be done in your Midtown Manhattan doctor’s office. The entire procedure usually takes less than a half hour to complete. The procedure follows specific steps:

  1. First, you’re made comfortable on an x-ray table, lying face down. The x-ray machine delivers continuous fluoroscopic images that help your doctor place the injections exactly where they’re needed.
  2. You may receive intravenous medicine to relax you, but this isn’t general anesthesia. You remain conscious during the procedure.
  3. Your qualified pain management doctor in Manhattan, NY applies a topical anesthetic to numb your skin so you won’t feel the initial prick of the needle.
  4. The fluoroscopic images guide your doctor to the sympathetic nerves where your pain originates. A contrast dye is injected first, to make the area easier to see on the fluoroscope.
  5. Once the exact spot along your spine is identified, your doctor injects the medicine — a combination of saline, local anesthetic and steroidal anti-inflammatory drugs — all around the area.
  6. After withdrawing the needle, a small bandage is placed over the injection site.

After the Procedure

Your back pain should ease right away, as the local anesthetic gets to work. It’s possible that your back or legs may feel numb for a few hours. Your legs may even feel weak during this time. These temporary side effects are from the anesthetic, which stops working after a few hours.

In the case of a stellate gang block, you shouldn’t feel any numbness in your face, but you may have a droopy eye temporarily. This and any other side effects disappear as the local anesthetic wears off.

Your pain may return at this time because the steroid medication hasn’t yet begun to work its magic. The steroids reduce inflammation, which in turn eases your pain. But it may take as long as two days after the injection for you to feel these effects. In the meantime, your doctor may prescribe prescription-strength pain relievers for a short duration.

I just had a lumbar sympathetic nerve block performed by Dr. Melepura, and the benefits were almost immediate. With just one injection, my pain was reduced by 50%!

Walter M.

Results from the Nerve Block

A lumbar sympathetic nerve block and a stellate gang block both stop the symptoms of pain. They don’t heal your problem by themselves. But by allowing you to relax without pain, your body can better heal itself. If successful, the effects of the injections last for several months.

If the procedure doesn’t deliver

long-term pain relief, you can repeat it in several weeks. But you can’t rely on this technique forever, as the steroid medication can affect your bones. Other risks, which are all rare, include:

  • Bleeding
  • Infection at the injection point
  • Infection at your nerve
  • Nerve damage
  • Temporary headache

Frequently Asked Questions

What Is a Sympathetic Block?

A sympathetic nerve block involves injecting numbing medication with or without steroid around a specific group of nerves involved in the body’s sympathetic nervous system. These nerves have been linked to pain when they are damaged or are misfiring. The sympathetic nerves are a chain of nerves that spread out from your spine. They prep your body for fight or flight at times of stress and help control your body’s involuntary functions—or body functions that you can’t control—such as pain, digestion, blood flow, and sweating.

What Does a Lumbar Sympathetic Block Do?

A lumbar sympathetic block works to “block” the sympathetic nerves that run to your leg on the same side as that of the injection. This, in turn, helps reduce pain, swelling, and sweating as well as improves mobility.

How Does a Sympathetic Block Work?

A sympathetic block helps switch off pain signals by injecting an anesthetic (numbing) medication into the sympathetic nerves near your spine. If these nerves are the source of your pain, the sympathetic block may offer relief for some time after the procedure. If effective, your doctor may recommend a series of these blocks 1-2 weeks apart, which may give you more long-term pain relief.

Are Sympathetic Nerve Blocks Covered by Insurance?

All insurance providers cover sympathetic nerve blocks provided that the initial diagnostic sympathetic block is medically necessary to establish the source of pain. Additional nerve blocks are covered when the initial procedure has been capable of: reducing your pain levels by at least 50%, noticeably reducing the use of your pain medication, and improving the function and strength of the affected part.

What to Expect After a Sympathetic Nerve Block?

After a sympathetic nerve block, your pain in the affected area may go away. You may stay pain-free longer than the duration required for the numbing medication to wear off, indicating that the block was effective. However, if this is not the case, your pain levels will not improve, showing that the sympathetic nerves were not the source of pain. And your doctor will then proceed with other tests to pinpoint the origin of the pain. If the block works, your doctor will most likely recommend a series of similar blocks every 1-2 weeks to achieve a more lasting benefit.

Moreover, when the numbing medication wears off, you may notice some increase in your pain levels, lasting for several days. Mild pain at the injection site is common. It will typically get better with icing during the first two to three days after the procedure.

If you received a sympathetic nerve block in your back (lumbar), there might also be increased warmth in your leg, lasting for several hours after the block.
If a nerve block was done in your neck area (stellate ganglion), you may notice a droopy eyelid, redness in the eye, or redness of the face. These effects, however, are normal and will subside within a few hours.

How Long Do the Effects of a Sympathetic Nerve Block Last?

It is not always possible to predict how long will a sympathetic nerve block lasts. If the block works, you may notice pain relief right away. However, your pain will return as soon as the numbing medicine wears off unless you have received a steroid shot (that takes time to kick in). Typically, the duration of pain gets longer after each successive injection. Thus, you will need a series of several sympathetic blocks to achieve long-lasting results.

How Is a Lumbar Sympathetic Nerve Block Done?

For a lumbar sympathetic block, you will lie face down on an x-ray table. You may receive a low-dose sedative to relax you. The skin on your back is cleaned with an antiseptic solution and numbed with a local anesthetic. Using X-ray guidance, a needle or needles is (are) then advanced into your back along the outside of your spine. Your doctor will then inject dye to ensure that the steroid medication will go to the correct spot. The drug is then injected slowly over several minutes under X-ray guidance. The needle is finally removed, and the treated area is covered with a Band-Aid.

What Is a Stellate Ganglion Block?

The stellate ganglion is where the sympathetic nerves for your arms come from. When the injection is done to block the sympathetic nerves from firing, it is called a block.

Who Performs a Stellate Ganglion Block?

A stellate ganglion block can be performed by pain management specialists.

What Does a Stellate Ganglion Block Treat?

A stellate ganglion is a cluster of nerves located at the front of your neck. A stellate ganglion block is an injection of numbing medicine to block the sympathetic nerves that run on either side of the voice box in your neck. Some of the common conditions treated by stellate ganglion block include complex regional pain syndrome, pain of the head and neck, and post-traumatic stress disorder (PTSD).

How Is a Stellate Ganglion Block Performed?

First, you will receive a relaxing medication. You’ll lie on your back on an x-ray table, and the front of your neck will be cleansed and numbed. Your doctor will use an x-ray or ultrasound guidance to guide the injection needle into your throat, close to your voice box. Contrast dye is injected to confirm the needle’s location before injecting the steroid (anti-inflammatory medication). The medication is then carefully injected, and the needle is finally taken out.

How Many Times Can You Repeat the Stellate Ganglion Block?

If your symptoms get better after the first shot, you will be suggested to get repeat injections. Usually, a series of such blocks is required to treat the problem. Some people report significant relief only after two to four sessions, while others may require more than four different sessions of injections. Ideally, the total number of blocks should not exceed six times.

How Long Does a Stellate Ganglion Block Last?

Predicting how long will a stellate ganglion block lasts varies from person to person. At times, blockade of the stellate ganglion can offer long-term relief. For most patients, however, a stellate ganglion block provides temporary relief. In general, the pain relief phase lasts longer with each repeated injection. At the end of the series of injections, most patients report 50% to 80% of pain relief that lasts for 6-12 months.

How Does a Stellate Ganglion Block Work?

A stellate ganglion is part of the sympathetic nervous system that supplies your face, neck, and arm. Hence, a blockade of this ganglion works to block pain signals in these parts of your body.

How Does Stellate Ganglion Block Help PTSD?

People with PTSD or people who have experienced an extremely traumatic situation have an increased “fight or flight response” (or an over-activated sympathetic nervous system). This response increases the levels of an adrenaline-like chemical, which, in turn, over activates the fear center of their brain called the amygdala.
The stellate ganglion is a part of the sympathetic nervous system that also oversees the activation of the amygdala. Though it is not precisely known how a stellate ganglion block works, it seems to calm down the exaggerated “flight or fight” response in people with PTSD. This helps to reset the amygdala. Thus, blocking the stellate ganglion helps alleviate the symptoms of PTSD immediately and offers long-lasting benefits.

Does a Stellate Ganglion Block Hurt?

Because a stellate ganglion block involves inserting a needle, the procedure does cause some soreness at the injection site. However, numbing your skin and deeper body tissues with a numbing agent using a very thin needle before advancing the actual block needle helps minimize pain.

Do you have any questions about the sympathetic nerve block to relieve your back pain we offer in NYC? Would you like to schedule an appointment with the best-rated spine doctor Febin Melepura MD of New York sports pain management clinic? Please contact our office for a consultation with the top pain relief specialist in Midtown Manhattan.

Page Updated on Oct 26, 2022 by Dr. Melepura (Pain Management Doctor) of Sports Injury & Pain Management Clinic of New York Sports Injury & Pain Management Clinic of New York
36 W 44th St #1416
New York, NY 10036
(212) 621-7746
Sports Injury and Pain Management Doctor NYC - Febin Melepura, MD

Febin Melepura, MD is a top rated, best in class interventional pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New York City and the country. He is an award winning expert and contributor to a prominent media outlets.

Dr. Febin Melepura has been recognized for his thoughtful, thorough, modern approach to treating chronic pain and, among other accolades, has been named a “top pain management doctor in New York”, and one of “America’s Top Doctors™” for an advanced sports injury treatments.

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