Treatment information
Understanding your pathway
What is the treatment?
The splanchnic nerves carry signals from some abdominal organs. A block places medication near these nerves and may be considered for selected visceral abdominal pain. It is not a treatment for every cause of abdominal pain, and is different from treating a painful muscle, joint or spinal nerve root. [1]
Who may be considered?
Selection follows assessment of the underlying abdominal condition and other treatment options. The pain specialist may need information from the team treating that condition. New or unexplained abdominal symptoms require medical evaluation; an injection should not substitute for investigating a potentially urgent or treatable cause. [1]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [2]
What happens during treatment?
The procedure uses imaging to guide needle placement near the intended nerves. A temporary local anaesthetic block differs from a procedure designed to destroy nerve tissue. If denervation or neurolysis is proposed, it requires a separate explanation of the technique, expected effect and additional risks. [1]
Risks and safety considerations
Potential risks include bleeding, infection, pain flare, low blood pressure and diarrhoea. The proximity of the lungs creates a risk of pneumothorax. Nerve or adjacent-structure injury can occur. Breathing difficulty, significant weakness or severe new pain after treatment requires prompt medical assessment. [1]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [3][2]
Expected benefit and limitations
A block may produce no benefit or only temporary relief and does not treat the underlying abdominal disease. Benefit from a temporary block does not guarantee the result of a more lasting intervention. Agree how pain, eating, sleep or other relevant function will be reviewed before considering further treatment. [1]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [2][4]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Coeliac plexus / splanchnic nerve blocks — East Kent Hospitals University NHS Foundation Trust
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia