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The causes of sympathetic nervous pain are quite complex. Chronic perineal pain from the ganglion impar area is often associated with poor blood supply to the nerves. In addition, visceral pain results from conditions of the abdominal organs and structures.

Before the procedure, you should notify the physician of any and all medications you are taking. In addition, you should arrange for someone to drive you home after the procedure. The night before you are scheduled to have the block, do not eat or drink after midnight.

Small sips of water are allowed with necessary medications, however. When you arrive at the medical facility, a nurse will go over the risks and benefits of the procedure and have you sign a consent form.

There are several approaches to the ganglion impar block, but the most commonly used is the transsacrococcygeal approach. In a recent study, this approach was found to be the easiest to perform, and it offered the most pain relief compared to other methods. During the procedure, you will be positioned on your stomach with pillows for support.

A nurse may place an IV catheter in your arm and attach monitoring devices to your body to assess heart rate, blood pressure, and oxygen. After the skin is cleansed with an antiseptic solution, the doctor will anesthetize the skin and soft tissues with a numbing agent. Using x-ray guidance, a needle is then positioned near the ganglion impar, and the doctor injects a mixture of a steroid and an anesthetic onto the nerves.

As with other minimally invasive procedures, the ganglion impar block can result in certain complications, but these rarely occur. Risks include nerve damage, bleeding, blood vessel injury, and infection. In addition, the steroid can cause weight gain, water retention, and elevated blood glucose.

According to a recent study, one injection offers 100% pain relief to the coccyx area. Pain relief can last for up to one month, depending on which medications are injected. Another study found that the technical success rate of the block was 100%, and more than 74% of the patients had either complete symptom relief or partial pain relief.

In one clinical study where the block was used to treat perineal pain, the majority of participants reported reduction in pain scores, with pain relief lasting for four months.

With this block, the symptoms of chronic rectal or pelvic pain is reduced by block nerve impulses. The ganglion impar block can be diagnostic (find what is wrong) or therapeutic (relieve pain). One of three things will happen with this block:

. The pain does not go away, meaning that it is not coming from the ganglion impar nerves (diagnostic value).
. The pain goes away and remains gone for several hours, but then returns. This indicates that the pain is related to the ganglion impar nerves, but the medication had no benefit (diagnostic value).
. The pain goes away after the block, and continues to improve over the next few days (therapeutic value).