Pain in the abdomen or pelvis can come from internal organs, peripheral nerves, or the sympathetic nervous system. Because these symptoms may overlap with gastrointestinal, gynecologic, urologic, neurological, or other medical conditions, the right treatment begins with a careful evaluation and coordinated care when needed.
We commonly help patients experiencing:
Treatment options may include:
A celiac plexus block targets a group of nerves that carry pain signals from parts of the upper abdomen. It may be considered when the patient’s diagnosis and pain pattern suggest that this nerve pathway is involved.
A hypogastric block may be considered when pain involves structures in the lower abdomen or pelvis. The specific procedure recommended will depend on where the pain is located, the suspected source, and the patient’s prior diagnostic workup.
Treatment options may include:
Superior or inferior hypogastric blocks may be considered when the pain pattern suggests involvement of sympathetic nerve pathways serving the pelvic organs.
Selected peripheral nerve blocks may also be used when symptoms appear to follow a more localized nerve distribution. Treatment depends on the location of pain, prior evaluations, medical history, and response to earlier care.
Treatment options may include:
The type of sympathetic block selected depends on the location and pattern of the patient’s symptoms.
A stellate ganglion block targets sympathetic nerves in the neck that influence the head, neck, chest, and upper extremities. A lumbar sympathetic block targets sympathetic nerves serving the lower body. Celiac plexus and hypogastric blocks may be used for selected abdominal or pelvic pain patterns.
These procedures may be used to help evaluate whether the sympathetic nervous system is contributing to the pain while also providing targeted treatment.
Some patients report persistent pain or dysautonomia-type symptoms after COVID-19. These symptoms can vary significantly and may involve pain, fatigue, unusual sensitivity, or autonomic complaints.
Because Long COVID symptoms can be complex and may involve several body systems, treatment begins with a pain-focused evaluation and review of the patient’s broader medical care.
Treatment options may include:
A stellate ganglion block may be considered individually based on the patient’s symptoms, diagnosis, medical history, and prior treatment. It is not appropriate for every patient with Long COVID or dysautonomia-type symptoms.
Coordinated care may also be important when symptoms involve cardiology, neurology, pulmonology, primary care, rehabilitation, or other specialties.
Celiac plexus and hypogastric blocks are targeted procedures used to address selected patterns of abdominal, visceral, or pelvic pain.
A celiac plexus block may be considered for pain involving structures in the upper abdomen. A superior or inferior hypogastric block may be considered when pain involves the lower abdomen, pelvis, or pelvic organs.
A stellate ganglion block may be considered for selected sympathetically mediated symptoms involving the upper body or, on a case-by-case basis, certain Long COVID-related symptoms.
A lumbar sympathetic block may be considered for selected sympathetically mediated pain involving the lower body.
The provider will determine whether a sympathetic block is appropriate based on the pain pattern, associated symptoms, prior treatment response, and overall diagnosis.
Your evaluation may include a physical exam, a review of your symptoms and medical history, and a discussion of whether prior records, imaging, specialist evaluations, or additional diagnostic steps are needed to better understand your condition and recommend appropriate next steps.
We may ask about:
From there, your provider can discuss which treatment options may be appropriate for your specific diagnosis and goals.
Not all abdominal or pelvic pain comes from the same source. Visceral pain, localized peripheral nerve pain, and sympathetically mediated symptoms may require different treatment strategies.
Our approach focuses on:
