Abdominal and Pelvic Procedures


The ganglion impar is a cluster of nerves located in front of the coccyx (tailbone), where it comes together with the sacrum (a triangular bone located at the base of the spine). It is part of the sympathetic nervous system and is responsible for supplying innervation to the perineal structures. This includes the perineum, distal rectum, anus, distal urethra, scrotum, vulva, and distal vagina. Over-activity of these nerve cells can cause chronic pain.

A ganglion impar block can be used to diagnose chronic pelvic or rectal pain or to treat pain symptoms once the ganglion impar has been identified as causing it. The injection works by blocking the nerve impulses that send pain signals to the brain.

If you think the ganglion impar may be the source of your discomfort, it is important that you see a specialist to get a definitive diagnosis.


A ganglion impar block is an outpatient procedure. It takes about 10 minutes to do and may be performed under IV sedation.

For the procedure, you will be asked to lie down on your stomach. A pillow may be placed under your pelvis to flatten out your lower back. The skin on your lower back will be cleaned and prepped, and a local anesthetic will be injected to numb the area. The doctor will then use fluoroscopy (real-time X-ray guidance) to guide the block needle into the right spot. Contrast dye may be injected to ensure the needle’s placement is correct.

When the needle is in the right place, local anesthetic and steroid medication will be injected. Afterwards, the needle will be removed and a small adhesive bandage may be applied.


You may feel temporary pain relief after a ganglion impar block procedure, as a result of the local anesthetic. When the anesthetic starts to wear off, the pain will likely return, but it may be less severe than before.

If the ganglion impar nerves are what is causing your pain, you will start to notice more long-term relief once the steroid medication starts to work (typically within three to five days). The amount of time your pain symptoms are alleviated can vary from a few weeks to several months or even years. Subsequent injections may be necessary to control your pain long term.

To get help and put an end to your chronic pain, contact us today to make an appointment with one of our specially trained pain management experts. We have years of experience performing ganglion impar blocks and other procedures to treat chronic perineal and coccyx pain.

More information coming soon on the following procedures:
  • Celiac Plexus Block/Splanchnic Block
  • Celiac Plexus Neurolysis
  • Hypogastric Plexus Block
  • Pelvic Neuro-Modulation
  • Pudendal Nerve Block
Abdominal and pelvic