Dr. Justin Kruer is a pain management doctor that specializes in controlling pain when surgery is not an option or has already been performed. He works with his patients to find the best treatment plan that will avoid the risk of dependence and addiction to opioid medication.
What is a Sympathetic Nerve Block?
A Sympathetic Nerve Block is an injection to your neck or back to help manage chronic pain. Your sympathetic nerves run along both sides of your spine from the upper neck to the coccyx (tail bone). They are responsible for conducting sensation signals to the spinal cord from the body and the involuntary control of functions such as blood flow, digestion and sweating. Those regions of the body rich in nerve endings such as the fingers, hands, wrist, and ankles are most commonly affected.
When a nerve is excited, its endings release chemicals. These chemicals cause vasodilation, an opening of the blood vessels. This results in inflammation or swelling which then leads to more stimulation of the sensory nerve fibers. Overtime an increased sensitivity to pain is developed. If you experience numbness, tingling, swelling, pain in your fingers, hands, wrists, ankles, or feet, this may be a treatment option for you.
What can I expect during the procedure?
All of our pain management procedures can be done in our procedure room, in our clinic setting, Suite A. Some people who require sedation (less than 5%) will discuss the option of having their procedure at our outpatient surgery center.
For this procedure you will lie on your stomach on an exam table. Dr. Kruer will numb an area of skin with a local anesthetic at the site that is causing your pain. Then, guided by a live x-ray (fluoroscopy) Dr. Kruer will insert a needle along the outside of your spine at the level generating your pain. He then injects a very small amount of dye through the needle, which he can see on the x-ray monitor, to confirm the needle head is in the correct location. He will then inject the steroid medication and anesthesia, and finally remove the needle.
Dr. Kruer’s orthopedic assistant will be there to make you comfortable and operate the c-arm (x-ray) equipment. Usually, the procedure takes less than 30 minutes, and you can go home soon after the procedure. You only need someone to drive you home if you receive sedation at the surgery center. Do not do any vigorous activity for 24 hours, after which you can resume normal activities.
You may feel numbness or weakness in your leg until the anesthesia wears off. Your back or leg may feel warm or different as you begin to feel less pain.
The risk of complication for this procedure are very low, but may include bruising or soreness at the injection site.
What can I expect with pain relief?
Everyone is so different and their response to a treatment is also unique. Some patients report pain relief immediately after the injection, but the pain may return a few hours later as the anesthetic wears off. Longer term relief usually begins in two to three days, once the steroid begins to work. Usually people need a series of injections to continue the pain relief. Sometimes it takes only two injections; sometimes it takes more than 10.
You may see a physical therapist during this period of time when the pain is decreased. Exercises and activities will focus on restoring motion, strength, and function.
To Schedule an Appointment either call our Missoula clinic (406)721-4436 or request your appointment online Click Here
For questions: Call Dr. Kruer’s orthopedic assistant, Mikaila or Andy (406) 829-5577