A celiac plexus block may help evaluate or temporarily reduce selected upper abdominal, stomach-region, pancreatic, or cancer-related pain patterns.
Celiac plexus blocks can help diagnose and treat certain types of chronic abdominal pain. Dr. Siefferman explains how this procedure works, when it may be appropriate, and how it can help identify the source of upper abdominal pain.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine and Interventional Pain Specialist. The celiac plexus is the sympathetic nerve bundle that lives right around the aorta where the celiac artery exits. And this nerve bundle is responsible for sensation to the stomach, the upper GI tract, the pancreas, those organs right in that area.
So if someone has chronic pancreatitis, if they have pancreatic cancer, if we suspect a hypermobility associated condition like median arcuate ligament syndrome (MALS) or superior mesenteric artery syndrome (SMAS), we will often offer a celiac plexus block diagnostically to see if that turns off the pain and then confirms that the celiac plexus is indeed responsible for that pain. This is a block that I do under fluoroscopic guidance.
It can also be done with endoscopic ultrasound by a gastroenterologist or under CT guidance with an interventional radiologist. I do it with fluoroscopy because it’s the cheapest and easiest and least radiation except for the ultrasound and it’s a very successful way of doing it. If you have any questions about this, if you think this may be a procedure that would be a benefit, I’m happy to speak with you about our approach and talk about other options if this doesn’t make the most sense.
A celiac plexus block is a targeted sympathetic nerve block that may help evaluate or temporarily reduce selected upper abdominal, stomach-region, pancreatic-region, or cancer-related pain patterns. The celiac plexus is a network of nerves in the abdomen that helps transmit pain signals from certain upper abdominal organs.
At Manhattan Pain Medicine, celiac plexus block NYC care begins with diagnosis-first evaluation. The goal is to determine whether pain may be traveling through the celiac plexus, whether another abdominal pain source needs to be addressed first, and whether a block may fit safely into the patient’s broader care plan.
MPM specialists evaluate whether a celiac plexus block may be appropriate by carefully reviewing the patient’s abdominal pain pattern, diagnosis, imaging, GI history, oncology history, medication response, prior procedures, and red flags.Upper abdominal pain may come from visceral pain pathways, pancreatic-region disease, cancer-related pain, gastroparesis overlap, GI disease, abdominal wall nerve pain, vascular disease, pelvic pain, neuropathic pain, medication effects, or emergency abdominal conditions.
MPM considers whether a celiac plexus block, medication management, opioid therapy, pain psychology, sympathetic blocks, neuromodulation, GI coordination, oncology coordination, palliative care, or another pathway may be most appropriate.
Patients often search for a celiac plexus block in Manhattan when severe upper abdominal, stomach-region, pancreatic, or cancer-related pain has not improved enough with medication, GI care, oncology care, palliative care, or conservative treatment. Some patients are looking for a medication-sparing option, while others want to understand whether a nerve block may help clarify the pain pathway.
MPM approaches celiac plexus blocks as precision procedures, not general treatments for all stomach pain. A block may be diagnostic, therapeutic, or palliative depending on the clinical situation. It may provide temporary relief or help determine whether the celiac plexus pathway is contributing to symptoms. For cancer-related pain, the goals may also include comfort, function, medication burden, and coordination with oncology or palliative care. The procedure is considered only after careful evaluation, red flag screening, and review of risks, alternatives, and expectations.
Celiac plexus blocks fit within MPM’s Complex Chronic Pain and Autonomic dysfunction expertise because upper abdominal pain can involve overlapping visceral, sympathetic, neurologic, GI, oncologic, and nervous system contributors. A patient may have pancreatic-region pain, cancer-related pain, gastroparesis overlap, abdominal wall nerve pain, medication-related symptoms, or complex chronic pain that requires coordinated evaluation.
MPM uses celiac plexus blocks within a diagnosis-first framework. The block may provide temporary relief or help clarify whether visceral abdominal sympathetic pathways are contributing to pain. It is not a standalone cure and is not appropriate for every abdominal pain condition. Treatment planning may include medication management, opioid therapy, pain psychology, GI coordination, oncology coordination, palliative care, sympathetic blocks, spinal cord stimulation, dorsal root ganglion stimulation, or other advanced pain options when clinically appropriate.
Before a celiac plexus block, MPM reviews the diagnosis, abdominal pain pattern, medical history, imaging, medications, prior procedures, risks, alternatives, and post-procedure instructions. The block is directed toward the celiac plexus region, which is involved in transmitting pain signals from certain upper abdominal structures. Image guidance is typically used to support procedural planning and medication placement.
Patients may feel pressure, brief discomfort, back soreness, abdominal warmth, dizziness, temporary numbness, or a short pain flare. Some patients may experience temporary diarrhea or low blood pressure after the block. Relief, if it occurs, may be temporary and varies by diagnosis, medication used, and patient response. MPM reviews the response to determine whether the celiac plexus pathway appears clinically meaningful and whether additional care should be considered.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
A celiac plexus block is a targeted sympathetic nerve block that may help evaluate or temporarily reduce selected upper abdominal, stomach-region, pancreatic-region, or cancer-related pain patterns. The celiac plexus is a network of nerves in the abdomen that helps carry pain signals from certain upper abdominal organs. At MPM, the procedure is considered only after diagnosis-first evaluation, red flag screening, and review of whether the celiac plexus is a clinically reasonable target.
The celiac plexus is located deep in the upper abdomen near major blood vessels and the front of the spine. It carries pain signals from several upper abdominal structures, including areas associated with the pancreas and other visceral organs. Because this region is anatomically complex, a celiac plexus block requires careful planning, image guidance, and patient selection. MPM reviews anatomy, diagnosis, imaging, medications, and safety factors before recommending treatment.
A celiac plexus block may be considered for selected upper abdominal, stomach-region, pancreatic-region, visceral abdominal, or cancer-related pain patterns. It is not a general treatment for all abdominal pain. Pain from GI disease, abdominal wall nerve entrapment, pelvic pain, vascular disease, infection, bowel obstruction, medication effects, or urgent abdominal conditions may require different evaluation or treatment. MPM determines whether the pain pattern fits the celiac plexus pathway.
A celiac plexus block may help selected chronic abdominal pain patients when symptoms suggest visceral upper abdominal pathway involvement. It does not cure chronic abdominal pain and is not appropriate for every abdominal pain condition. MPM evaluates whether pain may be related to GI disease, pancreatic-region disease, cancer-related pain, gastroparesis, abdominal wall nerve pain, pelvic pain, vascular disease, neurologic pain, or central sensitization before recommending this block.
A celiac plexus block may be considered for selected stomach-region or upper abdominal pain patterns when visceral pain pathways appear involved. Stomach pain can also come from ulcers, inflammation, infection, gallbladder disease, bowel disease, gastroparesis, medication effects, vascular conditions, cancer-related causes, or urgent abdominal problems. MPM evaluates the underlying diagnosis and appropriate specialty care needs before determining whether a celiac plexus block may be reasonable.
A celiac plexus block may be considered for selected cancer-related upper abdominal pain, especially when pain may travel through the celiac plexus pathway. In cancer care, the goal may be symptom relief, improved comfort, reduced medication burden, or palliative support. It does not treat the cancer itself and does not replace oncology or palliative care. MPM coordinates with the patient’s treating clinicians when cancer-related pain is part of the picture.
A celiac plexus block may be considered for selected pancreatic-region pain, including some cancer-related or chronic pancreatic pain contexts. It is not appropriate for every pancreatic or abdominal condition. Pancreatic pain requires careful medical evaluation, imaging review, GI or oncology coordination when appropriate, and red flag screening. MPM determines whether a temporary block or another care pathway is more appropriate based on the diagnosis and patient safety factors.
A celiac plexus block can be diagnostic, therapeutic, or palliative depending on the clinical context. A diagnostic block may help determine whether the celiac plexus pathway is contributing to pain. A therapeutic block is intended to reduce symptoms for a period of time. In some cancer-related pain cases, the goal may be palliative symptom support. Relief varies, and MPM uses the response to guide next steps.
A celiac plexus block targets upper abdominal visceral pain pathways. A superior hypogastric plexus block targets lower abdominal and pelvic visceral pain pathways. These procedures are not interchangeable. MPM selects the target based on pain location, suspected organ or nerve pathway, diagnosis, imaging, prior response, safety factors, and treatment goals.
A celiac plexus block is generally considered for selected upper abdominal, stomach-region, pancreatic-region, or cancer-related pain patterns. A ganglion impar block is more often considered for selected tailbone, perineal, rectal, anal, genital, or lower pelvic pain patterns. MPM uses pain mapping and clinical evaluation to determine which target best matches the patient’s symptoms.
Relief varies by diagnosis, medication used, pain pathway, and patient response. Some patients may experience relief for hours or days, while others may have longer improvement. Some patients may not respond. Relief is not guaranteed and is often temporary. MPM reviews the timing, location, degree, and duration of relief to determine whether the celiac plexus pathway appears clinically meaningful.
Temporary relief can still provide useful diagnostic information. It may suggest that upper abdominal visceral pain signals are traveling through the celiac plexus pathway. Depending on the response, MPM may consider medication management, opioid therapy review, pain psychology, GI coordination, oncology coordination, palliative care, sympathetic blocks, spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options. If relief is limited or absent, the diagnosis may need refinement.
Celiac plexus neurolysis is different from a temporary celiac plexus block. Neurolysis uses medication intended to disrupt nerve signaling for a longer period and is most often discussed in selected cancer-related pain or palliative contexts. The risks, goals, and consent process are different from a diagnostic or temporary block. MPM reviews whether temporary block, neurolysis, medication management, palliative care, or another pathway is most appropriate.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, diarrhea, low blood pressure, dizziness, back pain, temporary weakness or numbness, vascular injury, organ injury, local anesthetic toxicity, incomplete relief, temporary relief only, or no relief. Neurolytic procedures have different risks and goals and require specific informed consent. MPM reviews risks, alternatives, and safety factors before treatment.
A celiac plexus block may not be appropriate when symptoms do not suggest upper abdominal visceral pathway involvement, when another diagnosis should be evaluated first, or when risks outweigh potential benefit. It is not a replacement for GI evaluation, oncology care, surgery evaluation, vascular evaluation, medication management, pain psychology, palliative care, neuromodulation evaluation, or emergency care when needed.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If you are considering a celiac plexus block in NYC for upper abdominal pain, stomach-region pain, pancreatic-region pain, cancer-related abdominal pain, or complex visceral pain, MPM can help determine whether this treatment may be appropriate. Your evaluation will consider your diagnosis, symptoms, imaging, prior care, safety factors, and treatment goals before any recommendation is made.
A celiac plexus block is a targeted sympathetic nerve block that may be considered for selected patients with severe upper abdominal, stomach-region, pancreatic-region, visceral, or cancer-related pain. The celiac plexus is a network of nerves deep in the abdomen that helps transmit pain signals from certain upper abdominal structures.
At Manhattan Pain Medicine (MPM), celiac plexus block NYC care begins with diagnosis-first evaluation. The goal is to determine whether the celiac plexus is a clinically reasonable target, whether the block may provide diagnostic or therapeutic information, and whether the procedure fits safely into the patient’s broader care plan.
The celiac plexus carries pain signals from several upper abdominal organs. In selected patients, pain from the pancreas, stomach-region, or other upper abdominal structures may travel through this pathway. This is why celiac plexus blocks are often discussed in the context of pancreatic-region pain, chronic upper abdominal pain, and cancer-related abdominal pain.
However, not all abdominal pain travels through the celiac plexus. Pain may come from GI disease, gallbladder disease, bowel disease, gastroparesis, abdominal wall nerve pain, pelvic pain, vascular disease, infection, inflammation, medication effects, neurologic pain, cancer-related causes, or emergency abdominal conditions.
MPM does not treat celiac plexus block as a general stomach pain injection. The evaluation begins with careful symptom mapping and red flag screening. This may include pain location, severity, timing, relationship to eating, nausea, vomiting, appetite change, weight loss, bowel symptoms, cancer history, imaging results, GI evaluation, oncology care, medication history, prior procedures, and functional impact.
This information helps determine whether pain appears visceral, abdominal wall-related, neuropathic, GI-related, vascular, pelvic, oncologic, or centralized. It also helps determine whether a celiac plexus block, medication management, opioid therapy review, GI coordination, oncology coordination, palliative care, spinal cord stimulation, dorsal root ganglion stimulation, or another neuromodulation pathway may be appropriate.
Celiac plexus block may be considered in selected cancer-related upper abdominal pain, especially when pain may be traveling through the celiac plexus pathway. In this setting, goals may include comfort, reduced pain burden, medication-sparing support when appropriate, and coordination with oncology or palliative care.
A celiac plexus block does not treat cancer and does not replace oncology care. In some cancer-related pain settings, celiac plexus neurolysis may be discussed separately. Neurolysis is different from a temporary block because it is intended to disrupt nerve signaling for a longer period. The goals, risks, and informed consent process are different.
Some patients with pancreatic-region pain or severe upper abdominal pain may be evaluated for a celiac plexus block. This may be considered when pain is persistent, severe, visceral in quality, and not adequately controlled with other appropriate treatments. The procedure may be used diagnostically, therapeutically, or as part of palliative symptom management depending on the diagnosis.
MPM evaluates whether the pain pattern matches the celiac plexus pathway or whether another source is more likely. For example, abdominal wall nerve pain, pelvic pain, bowel obstruction, vascular disease, infection, inflammatory disease, or urgent GI conditions require different evaluation and treatment.
A celiac plexus block may be diagnostic, therapeutic, or palliative. A diagnostic block may help determine whether pain signals are traveling through the celiac plexus. If temporary relief occurs in the expected area, that response may support celiac plexus pathway involvement.
A therapeutic block is intended to reduce symptoms for a period of time. Relief may last hours, days, weeks, or longer, and some patients may not respond. MPM reviews the location, degree, timing, and duration of relief before recommending next steps.
If a celiac plexus block provides temporary relief, MPM may consider whether additional sympathetic treatment, medication management, opioid therapy review, pain psychology, GI coordination, oncology coordination, palliative care, spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options should be discussed. If the block does not help, the care team may reassess whether symptoms are more consistent with GI disease, abdominal wall nerve pain, pelvic pain, vascular disease, neurologic pain, medication-related symptoms, or another pain generator.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, diarrhea, low blood pressure, dizziness, back pain, temporary weakness or numbness, vascular injury, organ injury, local anesthetic toxicity, incomplete relief, temporary relief only, or no relief. Neurolytic procedures have different risks and require separate informed consent.
Patients should seek urgent evaluation for severe or sudden abdominal pain, fever, persistent vomiting, black or bloody stool, vomiting blood, jaundice, fainting, chest pain, shortness of breath, new neurological deficits, severe back pain, unexplained weight loss, cancer-related red flags, bowel obstruction symptoms, severe dehydration, severe allergic reaction, or rapidly worsening symptoms.
For selected patients, a celiac plexus block may be an important step in understanding upper abdominal or visceral pain pathways. MPM’s role is to determine whether the procedure is appropriate, safe, and aligned with a coordinated care plan.
