FAQ’s on Ganglion Impar Block?

What is a Ganglion Impar Block?

The ganglion impar is a nerve bundle located near the coccyx (the tailbone), serving to provide sensation to surrounding tissue and the rectum. When a patient is experiencing chronic pain in their pelvis or rectum, a ganglion impar block can provide immediate relief by numbing the nerve cluster. This injection will stop the transmission of pain signals to the brain.

What will a Ganglion Impar Block treat?

The primary purpose behind a ganglion impar block is to treat chronic pain located in the pelvic region or the rectum. Ganglion impar blocks can also be effective in providing pain relief to specific abdominal conditions, based on their proximity to the pelvis. The ganglion impar nerve bundle contains fibers that branch into the vagina, the urethra, the anus, the vulva, and the perineum; meaning a block to these nerves can provide pain relief to any of these areas.

How is a Ganglion Impar Block performed?

A ganglion impar block is performed as an outpatient procedure, with local anesthetic applied to the site of injection. Patients who desire intravenous sedation may be able to request it. Patients will be placed in a prone position to provide the physician access to the spine and coccyx. Once properly positioned, the injection needle will be guided into the ganglion impar through the use of fluoroscopic imaging (a series of rapid X-rays used to create a real-time image of the needle’s location in the patient).

Once the needle has been correctly placed into the ganglion impar, a numbing agent will be injected to numb the nerve cluster.

How well does a Ganglion Impar Block work?

There are three common reactions to ganglion impar blocks:

  • Pain symptoms are not altered and do not fade. This is indicative that the block did not have a therapeutic effect on pain symptoms, but instead can be a reliable indication that the pain is being caused by another area of the body instead of the ganglion impar. This means that the procedure has provided a diagnostic benefit, which is a very important step in finding and treating the real root cause of pain for a patient.
  • The second possible response is that the symptoms a patient has recede for a short period of time, typically no more than a few hours, only to return and continue being a source of pain. This is also a beneficial diagnostic effect as it reveals that the ganglion impar is in fact the root source of pain, but the steroidal component (which extends the duration of relief) used was not effective for the patient. Changing the steroidal component used can provide extended relief for patients who receive this result.
  • The final possible outcome is that pain symptoms fade, return briefly at a much lower intensity, and then dissipate over the next few days. This is the ideal result for a therapeutic ganglion impar block, as both the numbing effect of the injection and the steroidal component served their intended purpose.

What are the risks of a Ganglion Impar Block?

There are very minimal risks associated with a ganglion impar block. The largest risks patients may face can include bleeding, infection, or soreness at the site of injection. There is also a small chance of patients experiencing an allergic reaction to the numbing agent or the steroid used.

In the very rare chance that the needle becomes dislodged during injection, there is a chance of numbing agent being unintentionally injected into the surrounding tissue. The largest risk faced by patients is that the injection will not be able to provide adequate amounts of pain relief to them.