Sympathetic Neural Blockade can be either a Diagnostic Procedure or a Therapeutic Procedure.
In the Diagnostic Procedure Section, we discuss the use of differential Sympathetic Nerve Blockade, a procedure that helps the minimally invasive interventional physician confirm where a patient’s pain generator is located.
Therapeutic blocks, on the other hand, are appropriate for alleviating pain, especially in a self-limiting disorder (e.g., postoperative, posttraumatic, or acute visceral pain syndromes). In general, they have been advocated to alleviate acute pain or an exacerbation of chronic pain and to provide direct and localized therapeutic action, especially in patients in whom pain is accompanied by swelling and inflammation. These procedures are performed in order to help the patient
- Remain ambulatory
- Maintain participation in a physical therapy or rehabilitation program
- Decrease the need for analgesics
- In some cases, avoid or delay surgical intervention.
- The Autonomic Nervous System (ANS) is divided into a sympathetic and parasympathetic component which function physiologically as opposites, that is, they balance each other. A number of pain conditions seem to be caused by dysfunction in the sympathetic nervous system. For instance, a stimulated sympathetic nervous system or direct nerve injury can lead to a burning painful condition. These conditions were named Reflex Sympathetic Dystrophy and Causalgia, however, more recently they have been re-named Complex Regional Pain Syndrome Type I and Type II.
- Sympathetic blocks in causalgia and reflex sympathetic dystrophy (ie, complex regional pain syndromes) give enough relief to patients so that they can participate in other treatment techniques that have found to be helpful in such situations. These additional treatments may include physical therapy and medication management. In some cases, therapeutic injections help the physician gain patient cooperation.
- Medical conditions for which therapeutic Sympathetic Neural Blockade has been found successful include:
- Peripheral vascular disease of the lower limbs (including intermittent claudication, gangrene following vascular surgery, arterial embolism, frostbite etc.)
- Sympathetically maintained pain (that may be associated with complex regional pain syndrome)
- Phantom limb and stump pain
- Herpes zoster neuralgia (shingles)