FAQs on Cervical Sympathetic Nerve Block

A cervical nerve block helps with upper back, shoulder, and neck pain. This block involves injecting targeted nerves with a long-acting anesthetic and/or neurolytic agent. The cervical spine has seven vertebrae, each separated by an intervertebral disc. At the posterior of these vertebrae are zygoaphosphyseal joints (facet joints).

Why is the cervical sympathetic nerve block done?

Cartilage in the facet joints often is damaged and wears thin over time and with age. The tiny joints often become enlarged, or bony growths occur (spurring) near or on the joint. This causes arthritis, pain, and swelling of the joints. The nerves that branch off the spinal cord through the facet joints will delay sensory signals. When joints get damaged, it can cause limited mobility, pain, and nerve compression.

What are the sympathetic nerves?

The sympathetic nerves run from the front region of the spinal column. These nerves are part of the autonomic nervous system, which control many functions like sweating, blood vessel constriction and dilation, and nerve function.

How do I prepare for the cervical nerve block?

Before having a cervical nerve block, you should tell the doctor about all medications you are taking. Certain blood-thinning agents and aspirin may be held beforehand. The patient may need approval for this procedure from their primary care physician. Because a mild sedative is given, you should not eat or drink for six hours beforehand, but are permitted to take usual medications with small sips of water. When you arrive at the surgical center, a nurse will discuss the risks and benefits of the procedure, and ask you to sign a consent form. Once you change into a gown, a staff member places an IV catheter in your arm and gives you a sedative.

What happens during the nerve block procedure?

You will be positioned your side of face-down for the procedure. Monitoring devices are used to assess heart rate, oxygen levels, and blood pressure. The doctor will clean the back of the neck with an antiseptic solution and drape the area. Once the area is numbed using lidocaine, the doctor inserts the procedure needle using x-ray guidance. After the medication is injected onto the nerves, the needle is removed, and a bandage is applied. The entire procedure takes around 30 minutes to complete.

What can I expect after the cervical sympathetic nerve block?

You will be monitored in the recovery area for about 30 minutes. Common side effects to expect include hoarseness, drooping of one side of the face, dropping of the eyelid, watery eyes, reddened eyes, and dilated pupils. These side effects are temporary and resolve.

What risks are associated with the cervical nerve block?

While complications rarely occur, these include blood vessel damage, nerve injury, loss of sensation, puncture of dura mater (membrane surrounding spinal cord), and infection.

Is the cervical sympathetic nerve block effective?

According to a recent research report regarding cervical sympathetic block and CRPS, around half of study participants reported complete pain relief, and an additional one-fourth reported partial relief of pain. Overall, the efficacy rate was 76%, with patients reporting pain relief for around 16 weeks.

Resources

Ackerman, W.E. & Zhang, J.M. (2006). Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome. Southern Medical Journal, 99, (10).

Cedars-Sinai. Cervical Block / Radiofrequency Ablation. Retrieved form:                               http://www.cedars-sinai.edu/Patients/Programs-and-Services/Pain-Center/Head-and-NeckPain/Cervical-Block—Radiofrequency-Ablation.aspx.

UW Health. Cervical Sympathetic Nerve Block (Stellate Ganglion Block). Retrieved from: http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMemberShow_Public_HFFY_1105110028072.html.

Yucel I, Demiraran Y, Ozuran K, & Degrimenci E (2009). Complex regional pain syndrome type I: efficacy of stellate ganglion blockade. J Orthop Traumatol, 10(4): 179-183.