sympathetic nerve block
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At the Center for Pain Relief, we treat patients with compassion and respect as we help them manage their pain. Located at the Medical Office Building at Pine Creek Medical Center in Dallas, our center primarily focuses on interventional pain management but also incorporates medical pain management.


I have been a patient of Dr. Manuel Ramirez for the last 18 years. I have a disease called RSD/CRPS or Reflex Sympathetic Dystrophy/Chronic Regional Pain Syndrome. It is a nerve problem which causes deteriorating bone problems and is very painful. He initially diagnosed me and has been treating my pain with success all these years and I claim him as “family.” He is professional, but also very caring, intelligent and kind and is a great listener.
Lou Ann T.Ardmore, Oklahoma

Sympathetic Nerve Blocks

Sympathetic nerve blocks are useful in diagnosing and treating pain that is caused by “hyperactivity” or “malfunction” of the sympathetic nerves, typically affecting the extremities and causing pain.  The sympathetic nerves are part of the autonomic nervous system that basically controls functions like blood flow to the organs and extremities, heart rate, blood pressure, sweating, digestion etc.  The sympathetic nervous system is also known as a “fight or flight” nerve in that it essentially is called upon by the brain to function in an “emergency” situation in the effort to maintain and save your life.  When it is hyperactive or malfunctions, it causes a variety of pain syndromes we label as Complex Regional Pain Syndrome.  The nerve is located along the entire spine in the front and slightly to the side of the spine.

A sympathetic nerve block involves injecting usually a local anesthetic around the sympathetic nerves in the lower back or neck area to relieve pain in the hopes of reducing or eliminating the pain.  If the block is successful, but the pain recurs, then repeated blocks 7-10 days apart may be indicated until the pain diminishes. If the sympathetic block is successful, the affected extremity will warm up, the blood vessels will be more apparent, and the pain will be relieved or diminished.  The pain relieving effect, however may only be temporary after the initial block..

The procedure is done under IV anesthesia and fluoroscopic (X-ray) guidance, thus you are instructed not to eat anything after midnight the day before the procedure and have somebody drive for you. You may take your routine medications with a small sip of water.  However if you are on blood thinners such as Coumadin or Plavix, please notify us so we can give you instructions on the timing to withhold these medications prior to the procedure.

If the procedure is repeatedly effective but short lived, radiofrequency neurolysis of the sympathetic nerve may be indicated to allow longer lasting pain relief.