Sympathectomy & Sympathetic Blocks
Radiofrequency Nerve Ablation
The sympathetic nerves run on the front surface of the spinal column and not in the spinal canal with the nerves that provide sensation and strength to your legs. The sympathetic nerves are part of the autonomic nervous system, which basically controls functions such as blood flow and temperature regulation to the arms and legs, sweating, heart rate, digestion, and blood pressure.
The autonomic nervous system is responsible for controlling bodily functions that you do not think about or have direct control over.
However, there is a connection between the central nervous system (that you have control over) and the autonomic nervous system. Regulation of the connection can become altered, usually secondary to an injury. When regulation of the sympathetic nervous system is altered, various pain states can occur including complex regional pain syndrome, also known as Reflex Sympathetic Dystrophy(RSD).
What is a sympathetic block and why is it helpful?
A sympathetic nerve block involves injecting numbing medicine around the sympathetic nerves in the low back or neck. By doing this, the sympathetic nervous system in that area is temporarily ‘switched’ off in hopes of reducing or eliminating pain. If pain is substantially improved after the block, then a diagnosis of sympathetically mediated pain is established. The therapeutic effects of the anesthetic can occur, at times, longer than would be normally expected. The goal is to reset the sympathetic tone to a normal state of regulation. If the initial block is successful, then additional blocks may be repeated if the pain continues to sequentially diminish.
What is a Sympathectomy?
Sometimes the Nerves that are blocked can be destroyed in exceptional cases. For example in patients with intractable abdominal pain from terminla pancreatic cancer a destruction of the celiac plexus can grant long term relief.
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