Electrotherapy – Electric Sympathetic Nerve Block

Electric Sympathetic Block (ESB) is among the services we offer to our Greenville, Spartanburg and Anderson area patients. It is an excellent method of electrotherapy for pain relief. Because this electrical stimulation procedure works best on sympathetic nerves, relief is most pronounced for painful conditions that have a sympathetic component. Doctors often refer to these conditions as Reflex Sympathetic Dystrophy (RSD) and Complex Regional Pain Syndrome (CRPS) but Fibromyalgia, back and neck pain, strained ligaments, and arthritis pain are common examples that may have a sympathetic component.

Patients appreciate electric sympathetic block because it electrically creates a pore, or pathway, within tissue instead of using a needle to mechanically porate the skin. Much like an electric garage door opener, computerized technology has configured the current to act directly on the nerve cell membrane’s voltage dependant gate.

While electrical skin burn is possible (in up to 3 percent of cases), due to the high frequency current used, tingling sensations or muscle contractions are the most common side effects. Most patients tolerate the procedure quite well and report a generalized feeling of relaxation or mild sleepiness afterward.

Anyone who experiences weather sensitive pain, burning pain or has complex, chronic pain might be considered a candidate for electric sympathetic block. While people with additional medical problems can make medical treatment more problematic, one very helpful side effect of this procedure is its ability to increase blood flow to the area treated. This is especially useful in the presence of vascular conditions such as peripheral arterial disease (PAD) and diabetic neuropathy.

Unlike traditional Transcutaneous Electric Nerve Stimulators (TENS) and physical therapy modalities that only offer relief while the unit is on, electric sympathetic block can provide long term, lasting relief. This is because the treatment works by stabilizing the cell membrane’s voltage dependant gate, making it less irritable. For comparison purposes, think of a weak battery that works fine once it is recharged.

If an electric sympathetic block is repeated daily for a week, its effectiveness increases with each additional treatment. While every case is different, and most people have more then one reason for their pain, when at least 25 percent immediate post-treatment relief is obtained with a trial block, then 5 out of 10 can achieve 75 per cent or more relief at the end of a week series.

Despite the absence of mechanical poration caused by chemical block derived from needle injection, typical effects of sympathetic block including Horner’s Syndrome (changed visual acuity with a droopy eyelid), nausea, vasal vagal reactions (fainting) and early or increased menses can occur. Given the potential for a good outcome, and since these effects are only occasionally bothersome, patients should be reassured when considering electric sympathetic block.

Additional professional medical journal publications concerning ESB are presented in these two review articles:
Electric Sympathetic Block, ÖZPMR, Österr. Z. Phys. Med .Rehabil 16/1 (2006) 3-10. (PDF)
Electric Sympathetic Block: Current Theoretical Concepts and Clinical Results, Journal of Back and Musculoskeletal Rehabilitation 10 (1998) 31-46. (Word)