A celiac plexus block is an image-guided injection used to interrupt pain signals carried through the celiac plexus, a network of nerves in the upper abdomen near the major blood vessels in front of the spine. It may be considered for selected patients with chronic upper abdominal visceral pain, including pain related to pancreatic disease or certain abdominal cancers.
The procedure can serve a diagnostic or therapeutic purpose depending on the medication used and the treatment goal. A standard celiac plexus block is different from celiac plexus neurolysis, which uses a neurolytic medication to intentionally disrupt nerve signaling for a longer period in carefully selected cases.
At Regenerative Spine and Pain Specialists, Dr. Zwade Marshall and Dr. Jennifer Xiong evaluate the cause and pattern of abdominal pain, prior treatment, imaging, medications, and overall health before recommending a celiac plexus procedure.
Request an Appointment or call (404) 618-0995 to schedule an evaluation at our Fayetteville, Marietta, or Atlanta office.
What Is a Celiac Plexus Block?
The celiac plexus is a network of nerves located in the upper abdomen near the aorta and the front of the spine. These nerves carry many of the pain signals that arise from upper abdominal organs.
A celiac plexus block places medication near this nerve network to temporarily reduce or interrupt those pain signals. Depending on the clinical goal, the injection may include local anesthetic and, in some situations, another medication selected by the physician.
The procedure may be used to help determine whether pain is being transmitted through the celiac plexus or to provide temporary therapeutic relief. It does not treat the underlying disease causing the abdominal pain.
Because abdominal pain has many possible causes, the diagnosis and pain pattern should be evaluated carefully before a celiac plexus block is considered.
Who May Be a Candidate for a Celiac Plexus Block?
A celiac plexus block may be considered when chronic or severe upper abdominal visceral pain appears to be carried through the celiac plexus and other appropriate treatments have not provided enough relief.
You may be evaluated for this procedure if you have:
- Persistent upper abdominal pain related to chronic pancreatitis in an appropriate clinical setting
- Pain related to pancreatic cancer or another selected upper abdominal malignancy
- A visceral pain pattern that may involve the celiac plexus
- Pain that has not improved enough with medications or other appropriate treatment
- A need for diagnostic information about whether the celiac plexus is contributing to the pain
A celiac plexus block is not appropriate for every cause of abdominal pain. Conditions involving the abdominal wall, spine, gastrointestinal tract, urinary system, or other structures may require a different evaluation and treatment approach.
Your provider will review your diagnosis, imaging, medications, bleeding risk, infection risk, blood pressure, medical history, and treatment goals before recommending the procedure.
What Conditions Can Celiac Plexus Blocks Help Manage?
Celiac plexus blocks are generally used for selected visceral pain conditions involving the upper abdomen rather than for nonspecific abdominal pain.
Chronic Pancreatitis
Chronic inflammation of the pancreas can cause persistent upper abdominal pain that may radiate toward the back. In selected patients, a celiac plexus block may be considered as part of a broader treatment plan.
Pancreatic Cancer-Related Pain
Pain from pancreatic cancer can be transmitted through the celiac plexus. A block, or in selected cases a different procedure called celiac plexus neurolysis, may be considered as part of pain management and supportive care.
Selected Upper Abdominal Cancer Pain
Some other abdominal malignancies can produce visceral pain transmitted through the celiac plexus. Whether a celiac plexus procedure is appropriate depends on the cancer location, pain pattern, overall treatment plan, and medical condition.
Other Selected Visceral Pain
In some cases, the procedure may be used diagnostically or therapeutically when the clinical evaluation suggests that the celiac plexus is an important pathway for the patient’s pain.
The procedure does not replace evaluation and treatment of the underlying abdominal condition.
Celiac Plexus Block vs. Celiac Plexus Neurolysis
A celiac plexus block and celiac plexus neurolysis target the same general nerve network, but they are not the same procedure.
Celiac Plexus Block
A standard block usually uses local anesthetic, sometimes with another medication selected by the physician, to temporarily reduce nerve signaling. It may be used for diagnostic information or temporary therapeutic relief.
Celiac Plexus Neurolysis
Neurolysis uses a neurolytic medication, such as alcohol or phenol, to intentionally disrupt nerve signaling for a longer period. It is more commonly considered for selected cancer-related pain and requires careful evaluation of the expected benefits and risks.
The fact that a patient has abdominal pain does not mean that neurolysis is appropriate. Your physician will determine whether a temporary block, neurolysis, another intervention, or continued medical management better fits the clinical situation.
How Does a Celiac Plexus Block Work?
The procedure places medication near the celiac plexus to reduce the transmission of visceral pain signals from the upper abdomen.
Using image guidance, the physician advances one or more needles toward the celiac plexus while avoiding nearby organs and blood vessels. The exact approach can vary based on anatomy, the procedure being performed, and the type of imaging guidance used.
Contrast may be used when appropriate to help confirm needle position and medication spread. The physician then injects the planned medication near the nerve network.
If a temporary local anesthetic block is being performed, the response can provide information about whether the celiac plexus is contributing to the pain. Therapeutic relief can vary in degree and duration.
What Happens During a Celiac Plexus Block?
A celiac plexus block is performed with image guidance and an anesthesia plan selected for your medical needs and the approach being used.
You may be positioned on your stomach, side, or back depending on the technique. The treatment area is cleaned, and local anesthetic is used at the skin. Additional medication for comfort may be used when appropriate.
The physician advances one or more needles toward the celiac plexus using fluoroscopy, CT, or another appropriate imaging technique. Needle position is checked carefully because the celiac plexus lies near major blood vessels and abdominal organs.
After the medication is injected, the needles are removed and you are monitored for changes in pain, blood pressure, and other symptoms before discharge.
What to Expect Before, During, and After a Celiac Plexus Block
Before the Procedure
Your provider will review the reason for the block, your pain pattern, imaging, medications, and medical history. Follow the office instructions regarding eating, drinking, medications, transportation, and arrival time.
Tell your care team if you:
- Take blood-thinning or antiplatelet medications
- Have an active infection, fever, or recent illness
- Have allergies to medications or contrast material
- Have significant heart, lung, kidney, liver, or other medical conditions
- Have diabetes
- Have a history of low blood pressure or fainting
- Are pregnant or may be pregnant
- Have had recent changes in your health
Do not stop prescription medications unless the prescribing or treating clinician specifically instructs you to do so.
During the Procedure
Your physician uses image guidance to position the needle or needles near the celiac plexus and inject the planned medication. Your vital signs are monitored throughout the procedure.
After the Procedure
You may be observed for a period after the injection because temporary low blood pressure, lightheadedness, diarrhea, or soreness can occur. Your care team will provide individualized instructions about driving, activity, medications, eating, and follow-up.
Contact the office promptly if you develop fever, increasing redness or drainage, severe or worsening abdominal or back pain, new weakness or numbness, fainting, shortness of breath, chest pain, or another concerning symptom.
Risks, Side Effects, and Safety Considerations
Celiac plexus blocks are image-guided procedures performed near major blood vessels, nerves, and abdominal organs, so both temporary side effects and uncommon serious complications are possible.
Potential risks and side effects include:
- Temporary low blood pressure or lightheadedness
- Temporary diarrhea
- Soreness or bruising at the injection site
- Temporary increase in pain
- Bleeding or hematoma
- Infection
- Medication or contrast reaction
- Injury to a nearby blood vessel or abdominal organ
- Nerve injury or other neurologic complication
- Collapsed lung with certain needle approaches
- Failure to relieve pain
Serious neurologic, vascular, or organ complications are uncommon but can be significant. The specific risks depend on the approach, anatomy, medication used, underlying disease, and the patient’s medical condition.
Celiac plexus neurolysis has additional considerations because it intentionally disrupts nerve signaling and should be discussed separately when it is being considered.
How Soon Can a Celiac Plexus Block Help?
If local anesthetic is used, some patients notice a change in pain relatively soon after the procedure. The immediate response can be temporary and may help show whether the celiac plexus is an important pathway for the pain.
When the procedure is being used therapeutically, the degree and timing of relief vary. Some patients obtain meaningful relief, while others experience only partial or short-lived improvement.
A lack of relief does not necessarily mean the pain is not real. It may indicate that the celiac plexus is not the primary pathway carrying the pain or that another pain source needs to be evaluated.
How Long Can Relief From a Celiac Plexus Block Last?
The duration of relief varies based on the underlying condition, the medication used, whether the procedure was diagnostic or therapeutic, and the individual patient’s response.
A local anesthetic block may provide relatively short-lived relief. Other medication choices may produce a different duration of benefit. No specific duration can be guaranteed.
Celiac plexus neurolysis is a separate procedure intended to provide longer-lasting interruption of nerve signaling in selected cases, particularly some cancer-related pain situations.
Because the underlying disease may continue to change over time, pain management often requires ongoing reassessment rather than relying on a single procedure.
Can a Celiac Plexus Block Be Repeated?
A celiac plexus block may be repeated in selected patients when the diagnosis, prior response, medical condition, and treatment goals support another procedure.
Repeat treatment is not automatic. Your provider will consider:
- How much relief the previous block provided
- How long the benefit lasted
- Whether the pain pattern or underlying disease has changed
- Medication and bleeding risks
- Whether a different procedure, including neurolysis in selected cases, is more appropriate
- Whether another source of pain should be investigated
The plan should be individualized rather than based on a fixed schedule.
What Happens If a Celiac Plexus Block Does Not Help?
If the block does not provide meaningful relief, your provider may reassess the diagnosis and whether the celiac plexus is actually the main pathway carrying the pain.
Depending on the clinical situation, next steps may include:
- Reevaluation of the abdominal condition and pain pattern
- Review of new or updated imaging
- Medication adjustments
- Coordination with gastroenterology, oncology, surgery, palliative care, or another appropriate specialist
- Repeating a diagnostic block in selected circumstances
- Considering celiac plexus neurolysis when clinically appropriate
- Considering a different interventional pain procedure
The goal is to identify the most likely pain source and treatment strategy rather than repeating an ineffective procedure automatically.
Why Choose Regenerative Spine and Pain Specialists?
Regenerative Spine and Pain Specialists provides comprehensive interventional pain management for patients with complex pain conditions.
Our physicians, Dr. Zwade Marshall and Dr. Jennifer Xiong, are Harvard-trained, double-board certified anesthesiologists and interventional pain management specialists.
Our approach to celiac plexus procedures includes:
- Careful evaluation of the diagnosis and pain pattern before recommending a block
- Image-guided needle placement
- Individualized medication and procedural planning
- Clear distinction between a temporary celiac plexus block and celiac plexus neurolysis
- Attention to bleeding, infection, blood pressure, and medication-related risks
- Coordination with other specialists when the underlying abdominal condition requires multidisciplinary care
- Care focused on symptom management and function without promising a specific outcome
Celiac Plexus Block Care in Fayetteville, Marietta, and Atlanta
Regenerative Spine and Pain Specialists offers evaluation for celiac plexus blocks through our offices in Fayetteville, Marietta, and Atlanta.
Fayetteville
Our Fayetteville pain management clinic is located at:
874 West Lanier Ave., Suite 250
Fayetteville, GA 30214
Marietta
Our Marietta pain management clinic is located at:
3939 Roswell Road, Suite 240
Marietta, GA 30062
Atlanta
Our Atlanta pain management clinic is located in Buckhead at:
371 E Paces Ferry Rd NE, Suite 802
Atlanta, GA 30305
Evaluation, procedure scheduling, and follow-up may occur at different locations depending on the treatment plan. Our team will confirm the appropriate location when scheduling.
For questions about celiac plexus blocks, call (404) 618-0995 or contact Regenerative Spine and Pain Specialists.
Frequently Asked Questions About Celiac Plexus Blocks
A celiac plexus block is an image-guided injection that places medication near the celiac plexus, a network of nerves in the upper abdomen, to temporarily reduce pain signaling from selected abdominal conditions.
The procedure may be considered for selected upper abdominal visceral pain, including chronic pancreatitis and some cancer-related pain. The underlying diagnosis and pain pattern determine whether it is appropriate.
No. A standard block usually uses local anesthetic for temporary interruption of pain signals. Neurolysis uses a neurolytic medication such as alcohol or phenol to intentionally disrupt nerve signaling for a longer period in selected cases.
Sometimes. A temporary response to local anesthetic can provide information about whether the celiac plexus is an important pathway carrying the patient’s pain.
The physician uses image guidance to position one or more needles near the celiac plexus and inject the planned medication while avoiding nearby organs and blood vessels. The exact approach can vary.
If local anesthetic is used, some patients notice a change relatively soon after the procedure. The timing and amount of relief vary, and immediate benefit may be temporary.
The duration varies depending on the underlying condition, medication used, treatment goal, and individual response. No specific duration can be guaranteed.
Potential risks include temporary low blood pressure, diarrhea, soreness, bleeding, infection, medication or contrast reaction, vascular or organ injury, nerve injury, collapsed lung with certain approaches, and failure to relieve pain.
It may be repeated in selected patients when the prior response, diagnosis, medical condition, and treatment goals support another procedure.
No. The procedure is intended to change pain signaling. It does not treat pancreatitis, cancer, or another underlying abdominal disease.
Your provider may reassess the diagnosis and pain source, review imaging, adjust medications, coordinate with other specialists, or consider another procedure when appropriate.
Regenerative Spine and Pain Specialists offers evaluation through its Fayetteville, Marietta, and Atlanta, Georgia locations. The scheduling team can confirm where the procedure and follow-up care are performed.
Schedule an Appointment for Celiac Plexus Block Evaluation
Chronic upper abdominal pain can be difficult to manage when it is driven by visceral nerve signaling and has not improved enough with other treatment. In selected patients, a celiac plexus block may be one option to consider.
Dr. Zwade Marshall and Dr. Jennifer Xiong can review your diagnosis, pain pattern, imaging, medications, and overall health to determine whether a celiac plexus block, celiac plexus neurolysis, or another treatment may be appropriate.
Request an Appointment online or call (404) 618-0995 to schedule with Regenerative Spine and Pain Specialists.
Patients can also review our financial options or contact our office with questions before scheduling.