What Are Sympathetic Nerve Blocks and When Are They Used?

Chronic pain can disrupt your life in ways that go beyond physical discomfort—it can affect your ability to work, sleep, and enjoy day-to-day activities. If you're dealing with long-term pain and standard treatments haven’t provided relief, a sympathetic nerve block may be an effective option.

At Greater Austin Pain Center, we specialize in advanced interventional pain treatments, including sympathetic nerve blocks. In this blog post, we’ll explain what these nerve blocks are, how they work, and when they’re typically used to manage pain.

Understanding the Sympathetic Nervous System

The sympathetic nervous system is part of your autonomic nervous system, which controls involuntary functions like blood flow, digestion, and heart rate. It also plays a key role in regulating pain signals, especially in cases of nerve-related or chronic regional pain.

When this system becomes overactive or misfires, it can lead to persistent pain even after an injury has healed.

What Is a Sympathetic Nerve Block?

A sympathetic nerve block is a minimally invasive injection that targets a specific portion of the sympathetic nervous system—the part of your body responsible for controlling involuntary functions like blood flow, sweating, and your body’s response to stress. In many chronic pain conditions, the sympathetic nervous system becomes overactive or misfires, contributing to long-lasting, hard-to-treat pain.

The procedure involves injecting a local anesthetic (and occasionally a steroid) near a sympathetic nerve group to “block” or interrupt pain signals from being sent to the brain. In doing so, the nerve block may relieve pain, reduce inflammation, improve circulation, or even confirm whether the pain is sympathetic in origin (diagnostic use).

These procedures are typically performed under fluoroscopy (live X-ray imaging) or ultrasound to ensure precise needle placement and enhance safety. Common sympathetic nerve block sites include:

Stellate Ganglion Block

Used to treat pain in the neck, upper chest, face, and arms—often associated with CRPS or shingles-related pain in those areas.

Lumbar Sympathetic Block

Targets the lower back, legs, and pelvic region. It’s often used for lower-extremity CRPS, vascular pain, or post-surgical nerve damage.

Celiac Plexus Block

Aimed at reducing severe abdominal pain, especially in patients with pancreatic cancer, chronic pancreatitis, or post-abdominal surgery pain.

Each block is tailored to the patient’s condition and symptoms, and it may be repeated in a series depending on response.

When Are Sympathetic Nerve Blocks Used?

Chronic Pain Conditions

Sympathetic nerve blocks are most often used for chronic pain syndromes that involve dysfunction in the sympathetic nervous system. These conditions often do not respond well to medications alone and may include:

• Complex Regional Pain Syndrome (CRPS): Characterized by persistent, severe pain often following an injury or surgery—typically affecting a limb.
• Reflex Sympathetic Dystrophy (RSD): An older term sometimes used interchangeably with CRPS, involving pain, swelling, and skin changes.
• Peripheral Neuropathy: Damage or dysfunction of the peripheral nerves causing burning, tingling, or numbness.
• Post-Surgical Nerve Pain: Pain that lingers long after a surgical incision has healed, possibly due to nerve involvement or inflammation.

These blocks are especially helpful when pain is neuropathic in nature—described as sharp, burning, or electric-like—and when there are visible signs like skin temperature changes or swelling.

Vascular and Circulatory Issues

The sympathetic nervous system also controls the narrowing and widening of blood vessels, which means it plays a role in blood circulation. When circulation is restricted or unbalanced, pain and dysfunction can occur. Sympathetic nerve blocks may help with:

• Raynaud’s Disease: A condition that causes blood vessels in the fingers and toes to constrict in response to cold or stress, leading to pain and color changes.
• Diabetic Neuropathy: A common complication of diabetes that damages the nerves in the legs and feet, often associated with poor circulation and burning pain.
• Peripheral Vascular Insufficiency: Decreased blood flow to the limbs, often causing coldness, pain with walking, or difficulty healing from wounds.

By improving blood flow and interrupting pain signaling, these blocks can offer both symptom relief and functional improvement.

Diagnostic Use

In some cases, a sympathetic block is used to determine if the sympathetic nerves are the source of your pain. If you experience significant relief following the procedure, it can guide your doctor toward a more specific and effective treatment plan.

What to Expect During the Procedure

Before the Block

Your provider at Greater Austin Pain Center will conduct a thorough evaluation, review your medical history, and may order imaging studies. You’ll receive instructions on how to prepare, which may include adjusting medications or fasting before the procedure.

During the Procedure

Sympathetic nerve blocks are usually done in an outpatient setting and typically take less than 30 minutes. You'll lie on a procedure table, and your provider will numb the skin before inserting a needle guided by imaging. You may feel slight pressure, but the procedure is generally well tolerated.

After the Block

After the injection, you'll be monitored for a short time. You may feel immediate relief, or it may take a few hours for the full effect. The duration of relief varies—some patients experience short-term relief, while others may benefit for weeks or months.

Potential side effects include temporary soreness at the injection site, low blood pressure, or dizziness. Most side effects are mild and resolve quickly.

Are Sympathetic Nerve Blocks Right for You?

Not every chronic pain condition is related to the sympathetic nervous system, which is why a full evaluation by a pain specialist is crucial. At Greater Austin Pain Center, we consider sympathetic nerve blocks when:

• Pain persists despite physical therapy or medications
• Pain seems nerve-related or circulatory in nature
• You need diagnostic clarity to guide your treatment
• These blocks may be part of a larger pain management strategy that includes physical therapy, medications, and lifestyle changes.

Take the Next Step Toward Relief

If you’re suffering from chronic nerve pain and want to know if a sympathetic nerve block might help, we’re here to guide you. With locations in Austin, Dripping Springs, San Marcos, Kyle, and throughout the Austin area, we’re committed to offering local, compassionate pain management care. 

Call us today or schedule an appointment online.