What is a "Sympathetic Reset?"

How Does a “Reset” Work?

What is the Sympathetic Nervous System?

The Sympathetic Nervous System (SNS) is a network of circuits inside the body but outside the central nervous system that allows us to subconsciously control essential functions like digestion, reproduction, blood flow, urinary system, etc.  Along with its counterpart, the Parasympathetic Nervous System (PNS), the SNS is aids in control of the most of the body’s internal organs. The SNS and PNS could be compared to two sides of a coin, as each tends to counteract the other and provide balance to the body. The SNS is known for allowing the body to function under stress in what is known as the fight or flight response, whereas the PNS seems to prefer a calmer state for the body. Research has shown that the SNS plays a major role in chronic pain, particularly neuropathic pain.[1] 

The SNS can either play a role in making chronic pain worse but increasing blood flow to painful and inflammed areas, or it can function as an escape route for pain signals to find their way around the normal set of checks and balances.  In either event, once the SNS becomes in involved in the picture, the pain becomes unresponsive to typical nerve blocks and seems to spread to involve other areas (i.e. left sided pain spreads to involve the right side as well, pain that started in the rectum or genitalia spreads to involve the perineum or the feet, etc).

Some of its functions in the pelvic region include:

• Filling and emptying the bladder by closing and opening sphincter
• Ejaculation
  
• Regulating blood flow to the pelvic organs and intestines
• Involuntary contraction of the pelvic floor

Neurons in the sympathetic nervous system are located in small structures called “ganglia.”  These ganglia are located in strategic areas throughout the body to regulate specific regions:

• Ganglion of Impar
• Superior Hypogastric Plexus
• Celiac Plexus
• Stellate Ganglion
• Sphenopalatine Ganglion

As all signals in the SNS travel through these ganglion at some point or other, they provide appropriate targets for pain management to aid in the treatment of “sympathetically-mediated” pain.[2]  Blocking the right ganglion or plexus can effectively block pain signals from an entire at once.  Unfortunately, the block will wear off as the medication is metabolized.  That is where amniotic fluid comes into play.  Read more on this part below…

Indications

A Sympathetic Reset is a useful treatment option for a variety of different types of chronic pelvic pain so long as the sympathetic nervous system is involved and playing an active role in the pain.  So how do you know if the sympathetic nervous system is involved?

  Has the pain spread to the opposite side or to another area?
  Has the area of pain become bigger than what it first started out as?
  Are you experiencing burning?
  Is the skin hypersensitive to the point that clothing hurts, or light touch hurts, or even the feeling of water from a bath causes pain?
  Are you experiencing pain with intercourse (i.e. men will feel pain with ejaculation, women feel pain during climax)?
  Are you feeling deep visceral pain (aka pain inside the area where your organs are)?
  Are you experiencing changes in the frequency of your urination and bowel movements?
  Are you feeling pain with bowel movements and/or urination? Have you been told you have IBS (Irritable Bowel Syndrome) or IC (Interstitial Cystitis)?

If you answered yes to any one of these questions, then chances are your SNS is involved and now playing an active role in your pelvic pain.  Unfortunately, standard nerve blocks and physical therapy will not be effective anymore.

Certain pelvic pain conditions have more of a tendency to trigger the SNS than others and move into the SNS at a much faster rate:

  Pudendal Neuralgia
  Levator Ani Syndrome
  Endometriosis
  Post surgical pain
  Vestibulitis
  Vulvdynia
  Prostatitis/Prostadynia

Like any treatment, do your research and ask lots of questions.  Do not rush into any treatment because it “sounds right” for you.  While there is no way to truly and consistently diagnose what is causing your pelvic pain, the most reliable means has always been a diagnostic block – as it pertains to a Sympathetic Reset, a diagnostic block of the Ganglion of Impar, Superior Hypogastric Plexus or both is the first step in seeing if you are a candidate for this therapy.

Nerve blocks are great treatments for pain…the only problem is they are temporary.  The medication (i.e. bupivavaine or ropivacaine) wears off after a few hours (sometimes a few days if a steroid is added), and then the pain comes right back.  Once the medication get metabolized the nerve wakes up, goes right back to the way it was before the injection and nothing is any different. 

Sympathetic nerve blocks, however, work slightly different because it isn’t just the nerves that are going to sleep and waking back up…it’s the sensors that regulate and measure remote parts of the body for the sympathetic nervous system that are getting turned off and awakened as well. On top of that, we are turning off the cell bodies, themselves, and essentially rebooting the entire circuit, all at once.  The combination of turning both the nerve endings, the cell bodies and the sensors at the same time gives the circuit an opportunity to recalibrate to a different level – hopefully, a normal level.

When the medication wears off and the sympathetic system in the area comes back on line, there is a brief window of time that the sensors and the cell bodies evaluate their surroundings to gauge what kind of condition/state the body is in and what it thinks it should be doing to influence that condition/state.  It is during this window that introduce amniotic fluid into the immediate area to create a euphoric environment for the sympathetic nervous system and trick it into calibrating itself for a body that is in a near perfect state, rather than a stressed and inflammed system that it last experience right before being turned off.

Sympathetic Block + Amniotic Fluid = Complete Reset

When the sympathetic nervous system was turned off, it was in overdrive sending more and more blood to areas that were already swollen and inflamed, sending signals into the spinal cord leading it to wind up and cause neurons to spontaneously fire, telling the adrenal glands to make more catecholamines and other part of the endocrine system to secrete cortisol – both of which cause more and more stress on the body.  It is doing all of this because it believes there is something wrong that it can fix if only it can send enough blood to the area and trigger enough of the body’s regenerative systems to start the healing cascade.  The only problem is there is nothing to heal at this point, and even if there was the cascade isn’t actually healing anything….rather it is making things even worse.  The worse things get, the more it rages on – creating a vicious that it cannot stop.  Sometimes, all one needs to do is just turn off the sympathetic nervous system in a certain area long enough for it to just give the body a break long enough so that when it wakes up from the nerve block, it sees a body in a calmer state that doesn’t need “saving.”  Unfortunately, that isn’t always the case, and it may just chose to go right back to where it left off if it doesn’t know any better, or rather it doesn’t find any signals that it should do something different…this is where amniotic fluid comes into play.

Amniotic tissue is rich with concentrated growth factors and elements that naturally induce healing by triggering the body’s natural regenerative pathways.  By itself, amniotic doesn’t actually heal anything, but rather what it can trick the human body into doing is what causes the healing process.  The shear presence of its contents are enough to coax the body into wanting to heal whatever is in the immediate area.  It is this “healing” state that we introduce around a slowly awakening sympathetic nervous system…essentially setting a stage for the circuit to wake back up, surrounded by an abundance of growth factors that make the system think everything is going well, everything is already in a healing state so it can stand down let whatever the body is clearly doing to heal merely finish.

Targets