Nerve Blocks & Interventional Procedures Conditions We Treat
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Celiac Plexus Block
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Stellate Ganglion Block
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Hypogastric Plexus Block
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Ganglion Impar Block
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Facet Joint Injections / Medial Branch Blocks
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Epidural and Nerve Root Blocks
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Sympathetic Blocks
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Peripheral Nerve Blocks
Celiac Plexus Block
Overview
The celiac plexus is a network of nerves in the upper abdomen that transmits pain signals from the pancreas, liver, stomach, and intestines. This block helps relieve severe abdominal pain, especially in chronic pancreatitis and upper abdominal cancers.
Symptoms
- Chronic abdominal pain unresponsive to oral medication
- Pancreatic or gastric cancer pain
- Deep, dull, or burning upper abdominal pain radiating to the back
- Pain interfering with appetite and daily activity
Diagnosis
- Imaging (CT or ultrasound) to localise the pain origin
- Pre-procedure evaluation of medications and coagulation profile
- Conscious sedation and local anaesthesia under sterile conditions
Treatment
- Performed under CT or fluoroscopic guidance
- Injection of local anaesthetic and corticosteroid (for temporary relief) or neurolytic agent (for long-term relief)
- Duration: 30-45 minutes; post-procedure observation for a few hours
Benefits
- Significant reduction in pain intensity
- Improved appetite, sleep, and quality of life
- Reduced need for strong opioids
Stellate Ganglion Block
Overview
The stellate ganglion is part of the sympathetic nervous system in the neck. This block helps relieve pain from the head, neck, upper chest, and arms caused by nerve injury or vascular conditions.
Symptoms
- Complex Regional Pain Syndrome (CRPS) of the upper limb
- Post-herpetic neuralgia in the neck or face
- Vascular insufficiency in the upper limbs
- Phantom limb or facial pain
Diagnosis
- Pre-procedure evaluation and ultrasound guidance for accuracy
- Monitoring of heart rate and temperature for response evaluation
Treatment
- Local anaesthetic injection around the stellate ganglion under ultrasound
- Duration: 20-30 minutes
- Repeated sessions may be needed for long-term control
Benefits
- Improved blood flow and reduced nerve hypersensitivity
- Relief from chronic neck and upper-limb pain
- Decreased anxiety and improved sleep in select cases
Hypogastric Plexus Block
Overview
The superior and inferior hypogastric plexuses are networks of nerves in the lower abdomen and pelvis that carry pain signals from pelvic organs. A hypogastric plexus block provides significant pain relief for pelvic cancers, endometriosis, and chronic pelvic pain.
Symptoms
- Pelvic pain due to gynaecologic or urologic cancers
- Endometriosis or chronic pelvic inflammatory conditions
- Pain after pelvic surgeries or radiation
Diagnosis
- Diagnostic imaging (CT or fluoroscopy) for accurate localisation
- Standard pre-procedure evaluation and monitoring
Treatment
- Needle placement under imaging guidance at the level of the L5-S1 vertebra
- Injection of local anaesthetic or neurolytic agent
- Typically performed under mild sedation
Treatment
- Reduced pelvic pain and discomfort
- Improved ability to perform daily activities
- Enhanced quality of life for cancer and post-surgical patients
Ganglion Impar Block
Overview
The ganglion impar lies at the front of the coccyx and transmits pain from the perineum, rectum, and tailbone area. Blocking this ganglion relieves coccydynia, chronic pelvic, and rectal pain.
Symptoms
- Tailbone (coccygeal) pain
- Perineal or rectal pain after surgery or trauma
- Pain from pelvic fractures or childbirth injuries
Diagnosis
- Pain assessment and MRI of the sacrococcygeal region
- Performed under fluoroscopic or CT guidance
Treatment
- Injection of local anaesthetic or neurolytic solution through a small needle
- Usually outpatient procedure (30 minutes)
Benefits
- Long-term relief from sitting or positional pain
- Improved mobility and function
Facet Joint Injections / Medial Branch Blocks
Overview
Facet joint injections target the small joints between the vertebrae that can cause chronic back or neck pain. These procedures are both diagnostic and therapeutic.
Symptoms
- Chronic neck or lower-back stiffness
- Pain worsened by twisting or bending backward
- Postural pain after injury or degeneration
Diagnosis
- Pain-mapping and motion testing
- Fluoroscopy or ultrasound to localise affected joints
Treatment
- Injection of local anaesthetic and anti-inflammatory medication
- Medial branch blocks target the nerves that supply the facet joints
- Radiofrequency ablation may be used for long-term pain relief
Benefits
- Decreased stiffness and pain
- Improved range of motion
- Restored ability to sit, stand, and bend comfortably
Epidural and Nerve Root Blocks
Overview
Epidural and selective nerve-root blocks deliver medication directly around irritated spinal nerves to reduce inflammation and relieve pain caused by disc prolapse, nerve compression, or spinal stenosis.
Symptoms
- Sciatica, cervical or lumbar radiculopathy
- Numbness or burning pain in arms or legs
- Disc prolapse or spinal stenosis
Diagnosis
- MRI to confirm nerve compression
- Performed under fluoroscopic or ultrasound guidance
Treatment
- Injection of corticosteroids and anaesthetic around affected nerves
- Outpatient procedure lasting 20-30 minutes
Benefits
- Rapid relief from radiating pain
- Reduced nerve inflammation
- Improved mobility and activity tolerance
Sympathetic Blocks
Overview
Sympathetic nerve blocks are used to treat pain caused by overactivity of the sympathetic nervous system, common in complex regional pain syndrome (CRPS), vascular pain, or autonomic dysfunction.
Symptoms
- Burning or aching limb pain
- Colour, temperature, or sweating changes
- Vascular insufficiency or Raynaudʼs disease
- Phantom-limb or chronic neuropathic pain
Diagnosis
- Clinical evaluation and autonomic testing
- Ultrasound or fluoroscopy for safe, accurate delivery
Treatment
- Injection of local anaesthetic near the sympathetic chain (lumbar or stellate
region) - Sometimes repeated for sustained effect
Benefits
- Reduced pain and nerve hypersensitivity
- Improved circulation and limb warmth
- Enhanced mobility and comfort
Peripheral Nerve Blocks
Overview
Peripheral nerve blocks target specific nerves outside the spine to manage pain in the limbs, face, or joints. They are useful for neuropathic, post-surgical, or trauma-related pain.
Symptoms
- Nerve pain in limbs or face
- Postoperative or post-traumatic pain
- Chronic joint or muscle pain
Diagnosis
- Ultrasound-guided localisation of the target nerve
- Outpatient setting under sterile conditions
Treatment
- Local anaesthetic or steroid injected around the nerve
- May be diagnostic or therapeutic
- Repeatable and safe under image guidance
Benefits
- Immediate pain relief
- Reduced dependency on oral medications
- Enhanced function and rehabilitation outcomes
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Gastroenterology FAQs
Are nerve block procedures painful?
Procedures are performed under local anaesthesia and sometimes mild sedation, so discomfort is minimal. Most patients tolerate them well.
How long does pain relief from a nerve block last?
Depending on the type of block, relief can last from weeks to months. Radiofrequency ablation can provide relief for 6–12 months or longer.
Is there any recovery time after a nerve block?
Most procedures are outpatient with minimal downtime. Patients can usually resume normal activities within 24–48 hours.
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