GANGLION IMPAR BLOCK

Experiencing any kind of chronic pain can greatly affect one’s daily life. This is especially true when the pain originates in a very uncomfortable or inconvenient area of the body. Those who suffer from chronic rectal pain, groin pain, or pelvic pain may struggle to achieve pain relief on their own. When this happens, it’s important to seek out interventional pain management from a qualified pain doctor’s office. Your doctor may recommend a ganglion impar block as a treatment for your chronic perineal pain.

At The Pain Relief Center, we offer a wide variety of treatment options for an even wider variety of painful conditions. Our goal for our patients is to either manage or eliminate chronic pain originating from nearly anywhere in the body. Patients seeking relief from chronic pelvic pain should consider undergoing a ganglion impar block procedure. It is a safe and easy procedure that can help you achieve powerful pain relief. To schedule an appointment with The Pain Relief Center, please call our office at 214-709-1904 today.

What Is a Ganglion Impar Block?

There are many methods pain specialists use in order to achieve pain relief for their patients. One of these methods is injections. In order to ease pain in pelvic and perineal structures, many pain doctors opt for what is called a ganglion impar block. A ganglion impar block is a minimally-invasive procedure that aims to soothe chronic pelvic and perineal pain.

Ganglions are places in the body where more than one nerve meets. Nerves are what receive pain signals and send them to the brain. When rectal pain, perineal pain, or genital pain occurs, the nerves from the pelvis and groin pass through what is called the ganglion impar en route to the brain.

During this procedure, your doctor will administer medicine at the injection site, which helps to block pain signals from this area of the body from reaching the brain. Patients who suffer from sympathetic nervous system pain, poorly localized pain or neuropathic perineal pain may greatly benefit from the procedure.

What Is the Ganglion Impar?

The ganglion impar is a sympathetic ganglion that is located just to the front of the sacrum. Keep in mind that the coccyx is the tailbone, not the sacrum. This is the lowest portion of the human spine. Nerve fibers pass through this ganglion on their way to the spinal nerves. Nerves from the following locations pass through the ganglion impar.

• Perineum
• Distal urethra
• The lower portion of the rectum
• Anus
• Vulva and vagina
• Tailbone

What Is the Purpose of a Ganglion Impar Block?

There are several uses for a ganglion impar block. For example, maybe you have chronic pain in the pelvic region due to damage or dysfunction of the organs in that area. Most doctors do not recommend this pain management procedure unless other methods have not worked for the patient. However, ganglion impar blocks can offer powerful pain relief for those who suffer from metastatic cancer pain.

Aside from being used for pain management or relief, these injections are also important in achieving accurate diagnoses. Let’s say that someone suffers from pelvic pain, but they’re unsure of its source. Doctors can use a ganglion impar block in order to determine if the ganglion impar is indeed the source of someone’s pain. After the injection, if the patient has a positive response to the medication, this can confirm the ganglion impar as the source of their pain.

Who Can Benefit from a Ganglion Impar Block?

Patients suffering from visceral or neuropathic pain in the lower pelvis or groin can benefit from a ganglion impar block performed by a qualified pain management specialist. The two most common uses for these blocks are back pain and perineal pain. Pain secondary to other conditions, such as a sexually transmitted disease (STD) or an inflamed prostate, likely will not respond well to these blocks.

Many patients who suffer from the following symptoms may find a ganglion impar block to be a truly life-changing procedure.

• Anal pain
• Severe pain, weakness, or difficulty sitting down
• Burning sensation pain
• Pain while having a bowel movement

How Can a Ganglion Impar Block Help Me?

Perhaps the most important benefit of ganglion impar blocks is their ability to treat visceral and sympathetic pain. They also allow patients to avoid surgery and powerful oral pain medications. Additionally, it is possible to undergo repeat injections should the effects of the first one wear off. The entire procedure is quick and painless, as the doctor will use a local anesthetic to numb the area. If you have pain that persists despite other attempts to remedy it, you may find effective relief from a sympathetic block such as this.

How to Prepare for a Ganglion Impar Block

Your healthcare provider will instruct you on how to prepare for this outpatient procedure. First, they need to know about your health history. Do you currently have any infections, a fever, or other important health issue? They will also ask whether or not you are on any blood thinning medications or if you have diabetes. If so, there may be certain special precautions you must take in order to have a safe procedure.

Additionally, let your doctor know what kind of medications you are taking currently. In some cases, they may ask that you refrain from taking certain medications for a few days before the procedure. Also, provide the following information for your doctor.

• If you are pregnant or if you could be pregnant.
• If this is your first procedure or a repeat procedure.
• Let them know if you have experienced complications with contrast dye, anesthesia, certain medications, or other injections in the past.
• Let them know of any and all allergies you have.

Lastly, we recommend that you arrange to have someone drive you home after the procedure. You may find that you still have a bit of discomfort for a few hours after the procedure concludes.

What Is the Ganglion Impar Block Procedure Like?

The entire procedure is very quick, and it should take no longer than an hour. Below, we explain the steps of a ganglion impar block procedure.

• The patient will lie down on their stomach on a table. This is called a prone position.
• Some patients will receive light sedation in order to relax, but most patients remain awake during the procedure.
• In order to ensure the safety of the patient, someone will closely monitor the patient’s vital signs and blood pressure.
• The injection site will be thoroughly cleaned and disinfected.
• The doctor will then administer a local anesthetic to the injection site to numb the area. This ensures that the patient feels no pain during the procedure.
• Then, the doctor inserts a thin needle into the injection site, which should be around the tailbone area. In order to guide the needle and ensure good needle placement, the doctor will likely use CT imaging, ultrasound, or X-rays with contrast dye.
• Once they ensure proper placement, your doctor will inject medicine into the area. Depending on the purpose of the injection, the type of medicine may differ. If the patient feels a burning or warm sensation at the treatment site, this is a normal side effect.

What Happens After a Ganglion Impar Block?

Once the medicine is injected, your doctor will remove the needle. You will then be closely monitored for around 30 to 60 minutes. Someone will closely watch your vital signs until your doctor says you can go home. Have someone drive you home and refrain from doing anything strenuous for the rest of the day.

Your doctor will likely tell you what you should not do, but be sure to ask them if you have any specific questions. You shouldn’t have any restrictions on food or beverages after the procedure. Follow all of your doctor’s post-procedure instructions. Although you may feel a bit of pain for a few days after the local anesthetic wears off, it is only temporary. If you experience any of the following symptoms, contact your doctor immediately.

• Fever
• Signs of infection, such as redness, inflammation, or oozing
• Numbness or weakness in your legs
• Severe pain
• Changes in the function of your bowels or bladder, such as bladder incontinence

Is a Ganglion Impar Block Permanent?

No. However, many patients feel relief from their pain for up to several weeks or a few months at a time. The length of time that you have relief generally depends on the type of medicine your doctor administers. Some patients have pain relief for only a few days or a few weeks, but there is solid evidence that some may have permanent relief from this treatment.

How Many Treatments Will I Need?

This depends on a few different factors. You’ll likely undergo at least one, if not two, diagnostic procedures in order to confirm the source of your pain. Once confirmed, you will undergo one more procedure in order to actually perform the block. This usually provides relief from pain for a few months at a time. After this, the number of treatments you have depends entirely on how your body responds to the treatment.

When Should I Expect Results from a Ganglion Impar Block?

Most patients feel relief almost immediately after the injection takes place. You should at least begin to feel the effects before you ever leave your doctor’s office. After the therapeutic procedure takes place, it may be a few days before you feel the full effects of the treatment.

What Conditions Can a Ganglion Impar Block Be Used to Treat?

There are many specific conditions that ganglion impar blocks can help in terms of pain management or relief. We list these below.

• Endometriosis
• Distal urethra pain
• Non-malignant pain or malignant pain of the perineum
• Post-surgical pain
• Sympathetically-mediated pain in the region (such as from complex regional pain syndrome)
• Pain of the rectum or anus
• Chronic inflammation of the prostate
• Nerve root injury
• Neuropathic pain
• Bladder cancer
• Vulvar or vaginal cancer
• Scrotal cancer
• Anal or rectal cancer

Additionally, these blocks can be used to treat multiple areas of pain at once. While using the proper technique, your doctor can treat multiple structures simultaneously, meaning you’ll need only one doctor visit for effective relief from pain.

Risks and Side Effects of a Ganglion Impar Block

As with any significant outpatient procedure, there are risks and side effects associated with ganglion impar blocks. Your doctor should inform you of the risks before you agree to undergo the procedure. While it is not high risk, it still has certain basic concerns and potential risks, such as the following.

• Allergic reactions
• Infections
• Excessive bleeding
• Temporary blood sugar increases (if you have a steroid shot)
• Temporary soreness or pain
• Bloody stool
• Damage to nearby organs
• Skin breakdown or changes to the skin
• Rectal perforation

How Successful Are Ganglion Impar Blocks?

Many patients wonder about the efficacy of this procedure. This is an understandable concern of particular importance, as you want to know what the chances are that the procedure will work. Most patients, after their first procedure, will experience anywhere from 50 to 100% pain relief. It’s important to remember that not every patient’s body will react in the same way to ganglion impar blocks. Your doctor will be able to better evaluate your situation and determine whether or not you are a good candidate for this treatment.

Do You Have Persistent Pelvic or Groin Pain?

At The Pain Relief Center, we believe in obtaining a full understanding of the source of your pain prior to developing a treatment plan for our patients. It is extremely important for us to personalize each patient’s experience so that we can find the best solution for their pain. If you suffer from pain in your groin or in any pelvic structures, a ganglion impar block may be a valid solution for you. To schedule an appointment with us, please call our office at 214-709-1904 today.