Overview
Splanchnic nerve block is a targeted treatment used when upper abdominal pain is being driven by deeper visceral nerve pathways. The splanchnic nerves form part of the sympathetic nervous system and carry pain signals from the upper abdominal organs to the spinal cord and brain. When pain becomes persistent, severe, or difficult to control, targeting this pathway may help reduce pain intensity and improve daily function.
A splanchnic nerve block involves injecting local anaesthetic, sometimes combined with steroid medication, near the splanchnic nerves. This may calm nerve sensitivity and help confirm whether this pathway is contributing to symptoms. If the block provides meaningful but temporary relief, radiofrequency ablation may be considered to provide longer lasting benefit by reducing pain signal transmission from the same nerve pathway.
This approach is usually considered after appropriate medical assessment and when non interventional treatments have not provided adequate relief.
Who this treatment helps
Splanchnic nerve block or ablation may be considered for people with:
- Persistent upper abdominal pain after appropriate medical assessment
- Deep visceral pain that is aching, difficult to localise, or nerve related in pattern
- Abdominal pain linked to chronic inflammatory or functional conditions in selected cases
- Pain that disrupts sleep, eating, movement, or daily activity
- Symptoms not responding adequately to medication or supportive treatment
- Pain patterns where a nerve pathway treatment is clinically appropriate
A consultation is required to confirm suitability and ensure this treatment matches the pattern and suspected source of pain.
What is a splanchnic nerve block or ablation
A splanchnic nerve block is an image guided injection delivered near the splanchnic nerves. The injection usually contains local anaesthetic and may include steroid medication depending on the clinical situation. The aim is to reduce nerve sensitivity, calm pain pathways, and help confirm whether the splanchnic nerves are contributing to pain.
Radiofrequency ablation may be offered when a diagnostic block suggests that the splanchnic nerves are an important pain pathway. This minimally invasive treatment uses controlled heat delivered through specialised needles to reduce pain signal transmission from the targeted nerves. The nerves treated are sensory pathways, so the aim is to reduce pain without affecting strength or movement.
Fluoroscopy or CT guidance may be used to support accurate placement and safety.
What to expect during the procedure
- Consultant review and confirmation of the treatment plan
- You are positioned comfortably on the procedure table
- The skin is cleaned and numbed with local anaesthetic
- Imaging guidance is used to position the needle safely and accurately
- A small amount of contrast may be used to confirm placement where appropriate
- Medication is injected for a nerve block, or radiofrequency treatment is delivered for ablation
- You are monitored for a short period before discharge
Most procedures are completed as a day case.
After the procedure
After a splanchnic nerve block, you may notice temporary relief from the local anaesthetic, which can help confirm the pain source. Steroid effects, if used, may take several days to develop.
After ablation, it is normal to experience local soreness for a few days. Pain relief often develops gradually over two to six weeks as the nerve pathway settles.
Your consultant may advise:
- Avoid strenuous activity for 24 to 48 hours
- Gradually return to normal activity as comfort allows
- Continue rehabilitation or supportive care where recommended
- Keep a brief symptom record to track response over time
Benefits
- May reduce persistent upper abdominal pain by targeting a key pain pathway
- Can help confirm whether the splanchnic nerves are contributing to symptoms
- Minimally invasive and usually performed as a day case
- May improve sleep, comfort, and daily function
- May reduce reliance on medication in selected cases
- Ablation may provide longer lasting relief when diagnostic blocks are successful
Possible risks and side effects
Splanchnic nerve procedures are generally safe when performed by experienced clinicians using image guidance. Possible risks and side effects may include:
- Temporary increase in pain or soreness at the injection site
- Bruising or local tenderness
- Lightheadedness or temporary low blood pressure
- Allergic reaction to medication or contrast dye
- Infection or bleeding, which are rare
- Very rarely irritation of nearby structures
Your consultant will explain individual risks and how they are minimised.
When to consider other options
If symptoms do not improve, or if the pattern of pain suggests a different source, your consultant may discuss alternatives such as coeliac plexus block or ablation, abdominal wall nerve blocks where appropriate, trigger point injection for abdominal wall tension, medication optimisation, or multidisciplinary pain management and rehabilitation support.
Safety note
Please tell your consultant if you take blood thinning medication, have diabetes, allergies, active infection, are pregnant, or have had previous reactions to steroid, local anaesthetic, or contrast dye. You may need someone to accompany you home depending on the medications used.
Arrange a consultation to discuss whether splanchnic nerve block or ablation may be suitable for your abdominal pain.
You can also explore our abdominal pain treatments, view all pain treatments, or learn more about our pain management services.