Ganglion Impar Nerve Block Injections

Ganglion Impar, which is part of the sympathetic (fight or flight) nervous system, is a bundle of nerves that lie directly in front of the sacrum/coccyx (lower spine) joint.  A compressed or inflamed nerve can create shooting pain. When over-activity or irritation of this area occurs, the patient may experience chronic pain of the coccyx area. This is referred to as coccydynia.  Patients with this condition experience relief with localized anesthetic and, often times, localized injections are used in lieu of surgery because of its effectiveness in treating coccydynia.


As with all types of chronic nerve pain, there are many treatment options available including cryotherapy (extreme cold), medications and nerve blocking injections. Nerve Block injections involve injection of a numbing solution into a selective nerve in an attempt to treat and manage pain. The injection can include a steroid (to reduce inflammation) and/or lidocaine or marcaine (to reduce pain). Nerve block injections are used to effectively “turn off” such nerves, and thus reduce any associated inflammation. The effect of these injections lasts between one and four weeks and can be repeated as required. With some conditions however, patients report a total reduction in pain since the initial over- activity of the nerve has been counteracted. In some instances, the patient may experience a more long term loss of pain as a result of localized anesthesia.

The types of medications used are not predetermined, since many options are available. Of course, ultrasound or fluoroscopy (image-guided injections) may work best, since surface anatomy may not be enough to target the extremely small surface area of the nerves in question.

Remember, nerve blocks are not the best treatment for all pain types. Even when they are appropriate, they are usually more effective as part of a more comprehensive treatment strategy.

Depending on the circumstances, complete destruction of the nerve (as opposed to temporary numbing through a local anesthetic) could be considered. This is referred to as a rhizotomy. Aside from the obvious complications of nerve destruction, permanently damaging a nerve may inadvertently and inevitably damage the soft tissue adjacent to that nerve as well.

We offer ganglion impar nerve block injections for coccydynia.



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