For some types of pain, certain procedures might be recommended to help diagnose what’s wrong, to treat pain, or both. Because they involve using a needle or scalpel, these treatments are sometimes called invasive therapies. They include injections, spinal cord stimulation, implanted drug-delivery systems (“pain pumps”), or other therapies specific to the area causing pain.
An injection that blocks pain signals from being sent to the brain is called a sympathetic nerve block. The sympathetic nervous system is the nerves that control involuntary body functions, like blood flow and your heart rate.
One common sympathetic nerve block is a stellate ganglion [STEL-eyt GANG-glee-uhn] injection. A ganglion is a nerve cell cluster in the autonomic nervous system and sensory system. During a stellate ganglion nerve block, anesthetic [an-es-THET-ik] (or sometimes another solution) is injected to numb the ganglion causing pain. The injection can help to lessen or deaden chronic pain from symptoms such as:
- Spasms in the blood vessels
- Complex regional pain syndrome (CRPS)
- Some chronic stomach pain
Other therapies that may help reduce or relieve chronic spinal pain are:
- Rhizotomy [rahy-ZOT-uh-mee]
- Kyphoplasty [KY-fo-plas-tee]
- Vertebroplasty [VER-tu-bro-plas-tee]
Rhizotomy is different from a pain injection, since a special needle applies radiofrequency energy to destroy nerve cells near a joint in your spine. This keeps the nerves from sending pain messages to your brain.
Kyphoplasty and vertebroplasty offer a different approach for certain kinds of chronic back pain. They are similar procedures to each other: bone cement is injected into the spine to stabilize fractured vertebra, typically from osteoporosis [OS-tee-oh-puh-ROH-sis]. This can lessen pain as the fractured vertebra is supported so it doesn’t rest on the disc and put pressure on the spinal nerve.
A nerve block is a fairly safe procedure. You can usually go home the same day and return to normal activities after a little rest. If you have intravenous line (IV) sedation, you’ll need to arrange for someone else to drive you home.
Side effects may include a feeling of warmth, weakness, temporary pain, eyelid droopiness, temporary voice changes, or difficulty swallowing. Risks with nerve block injections or rhizotomies are rare, but could potentially include:
- Fever or chills
- Pain at the injection site
- Temporary numbness in the arm that lasts for a few hours, or temporary weakness or numbness from the neck down
- Seizure (if the medicine is injected into a blood vessel)
- Allergic reaction to medicine
- Collapsed lung
- Nerve damage
Treatments such as stellate ganglion block aim to reduce your level of pain and minimize its effect on your life, so you can do more of the things that make life enjoyable.
Before getting a stellate ganglion block or other sympathetic nerve block procedure, you will meet with a specialist experienced in conducting nerve blocks. You need to let them know of any medicines, vitamins, and supplements you are taking. It’s also important to inform them of any allergies. You may be asked to fast (not eat) for a few hours before the procedure.
You will usually need to go to a hospital for a sympathetic nerve block procedure. Your medical team will monitor your vital signs and may start an IV (a needle in your vein) to give you medicine that will make you sleepy.
The area of injection in your back will be numbed with a local anesthetic. The specialist may use x-rays or fluoroscopy to see your bones and tissues and to guide the needle to the right ganglion. Nerve pain in the ganglion is “blocked” by being injected with an anesthetic (or other solution) to calm and numb it.
If you received IV sedation, you will need to arrange to have someone drive you home. You’ll be able to return to normal activities after a day of rest.
You will know the same day if the procedure has been successful as you monitor your pain levels. In many cases, you will need a series of blocks for the best results.
The nerve block’s effects may lessen over time, but it could provide weeks or months of relief. Along with the blocks, your doctor may recommend that you use talk therapy, physical therapy, and/or pain medicine to best manage all of your symptoms.
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