This injection can both diagnose and treat pain coming from the sympathetic nerves. It is a common treatment for shingles and complex regional pain syndromes affecting the head, face, neck, or arms. Usually a series of these injections is needed to treat the problem.
All Non-Surgical Treatments
How is the procedure done?
Patients lie on their back on a table equipped with a special x-ray (fluoroscope) unit, and an intravenous (IV) line is started to administer medication that relaxes the patient. A local anesthetic numbs the skin and all the tissue down to the ganglion nerves. The physician slides a needle through the anesthetized track. A contract solution is injected so the physician can use an x-ray (fluoroscope) to see the painful areas and to confirm the correct location of the needle tip.
Next, a mixture of anesthetic, saline and anti-inflammatory medicine is injected around the ganglion nerves to block pain signals from reaching the brain. Common side effects include nasal congestion and a bloodshot, droopy eye on the side the injection was given, as well as a hoarse voice and a warm, tingling sensation in the arm and hand. They usually disappear after several hours. If the first injection alleviates pain, more will follow over time. Pain relief usually last longer after each injection.
What are the risks?
The risks of the procedure, though uncommon, include:
- Seizure (if the medication is injected into a blood vessel
- Pneumothorax (collapsed lung)
- Brachial plexus block (temporary numb arm that lasts for a few hours)
- Spinal or epidural block (temporary weakness or numbness from the neck down)
- Nerve damage
- Allergic reaction to medication
Will the injection hurt?
During the procedure the physician will press on your neck to locate the area to be injected, and many patients find this to be uncomfortable.
How will I feel after the procedure?
Your neck may be tender and you may experience a droopy eye on the side that the injection occurred. This may affect your sense of balance. Your voice may become hoarse and you may find it difficult to swallow for a short period of time.
What restrictions will I face after the procedure?
You should have someone take you to and from your appointment, as you will not be allowed to drive after the procedure. You will be instructed not to eat or drink anything for about four hours after the procedure, until you are able to swallow safely. You may resume regular diet and medications after this time period. You may resume regular activities the following day.
When should I call my doctor?
If you have severe pain, new numbness or weakness, or signs of infection at the injection site (redness, swelling or bleeding), you should contact us right away.