Sympathetic Blocks

These are also called selective nerve root blocks or sleeve injections

What are the sympathetic nerves?

The sympathetic nerves run on the front surface of the spinal column (not in the spinal canal with the nerves from the central nervous system).  The sympathetic nerves are part of the autonomic nervous systems which basically controls certain functions other than sensation and motor function.  In other words, the autonomic nervous system is responsible for controlling things people do not have to think about or have direct control concerning their function.  But, there is a connection between the central and autonomic nervous systems.  Sometimes arm and leg pain is caused by a malfunction of the autonomic system secondary to an injury.

What is a sympathetic nerve block?

A sympathetic nerve block involves injecting medicine around the sympathetic nerves, ganglion or chain in a lumbar or cervical area. 

Why is sympathetic block helpful?

The system is temporarily blocked in hopes of reducing or eliminating pain.  If the initial block is successful, then additional blocks are generally repeated and repeated again until the pain diminishes.

What happens during the procedure?

An IV will be started so that relaxation medication can be given.  The patient is placed on the x-ray table on their back for a cervical block and on their stomach for a lumbar block in the operating room.

This skin on the neck or the skin on the low back is scrubbed using alcohol.   Next, the physician numbs a small area of skin with numbing medicine. 

After the numbing medicine has been given time to be effective, the physician directs a very small needle, using x-ray guidance to the area of the sympathetic nerves.

A small amount of contrast (dye) is injected to insure proper needle position.  Then, a small mixture of numbing medicine (anesthetic), is injected.

What happens after the procedure?

Immediately after the procedure the patient will go back to the recovery area where they are monitored for 15-30 minutes.


The patient can eat a light meal within a few hours before the procedure. If a patient is an insulin dependent diabetic, they must not change their normal eating pattern prior to the procedure. Patients may take their routine medications. (i.e. high blood pressure and diabetic medications).

Post-procedure Instructions

You were given a number of medications during the procedure.  These sometimes include sedatives, narcotics, local anesthetics, steroids, and other medications.  Any of these drugs or procedure itself, sometimes can cause side effects, including drowsiness, temporary numbness, weakness and soreness.

What To Do After the Procedure?

Rest for a few hours and use assistance if needed. Resume activity as tolerated, but do not overdo. Resume regular diet.


Do not drive or operate machinery for at least 12 hours. Do not make important decisions for 12-24 hours after treatment. Walk with assistance as long as numbness, weakness, or drowsiness is present.

Notify If You Have:

Excessive or abnormal bleeding / persistent chills or fever over 100°F.If there is a major change in pain pattern or level.


In case of emergency, call (270) 554-8373.If unable to reach the physician, report to the nearest emergency room and request them to inform the physician at Pain Management Center.

Few Other Things:

Take your usual medication. Apply ice massage as instructed; may use heat if ice is intolerable. If IV site becomes painful, place warm towels on the site for 20 minutes2-3 times / day