What Is A Sympathectomy? Procedure, Recovery, Treatment

When you’re suffering from excessive sweating or any other nervous system disorder, you certainly need all the empathy you can get. But do you need a sympathectomy? This surgical procedure with the memorable name provides much-needed relief for some people. But no operation is without risk. Many patients seek less aggressive measures first -- often with good outcomes.

What Is Sympathectomy?

In this Article:

• Sympathetic Nerves and the Roles They Play
• Sympathectomy Indications
• Sympathectomy for Hyperhidrosis
• Possible Risks and Complications: Sympathectomy Side Effects
• Sympathectomy Alternatives
• Home Treatments for Hyperhidrosis

Sympathetic Nerves and the Roles They Play

https://twitter.com/Orthofacts/status/730921144618995712
The autonomic nervous system has two major classifications -- the sympathetic and the parasympathetic nervous systems. The sympathetic nerve bundle enables many of the functions that keep the body working properly. The main group of sympathetic nerves runs along the spinal column. Sympathetic nerves promote the occasional “fight or flight” response meant to warn people of imminent danger. On a daily basis, the sympathetic nerves also regulate organ systems.

With the aid of sympathetic nerves, sweat glands act as a coolant system to prevent overheating. They also enable eye dilation to help you see better in low-light conditions. The sympathetic nerve chain additionally regulates the heart, lung, and digestive and kidney functions.

Sympathectomy Indications

So, why block this useful bundle of nerves through surgical means? Sometimes it may be necessary. Like any other body system, sympathetic nerves can malfunction. They can actually signal certain functions to go into overdrive.

Hyperhidrosis
In the case of sweat glands, overactive nerve activity causes a condition called hyperhidrosis. People suffering from hyperhidrosis experience excessive sweating on the hands, feet, underarms, or face. The location depends on which part of the sympathetic nervous system becomes overactive. Usually, there is no direct medical reason for this.

Reflex Sympathetic Dystrophy
Overactive sympathetic nerves can cause problems other than hyperhidrosis. Another condition, reflex sympathetic dystrophy (RSD), is triggered by an injury or illness. RSD leaves patients feeling pain and sensitivity in the limb that was affected by the original trauma. With RSD, symptoms can’t be explained by the direct injury. They're believed to be "crossed wiring" of the sympathetic nervous system. Researchers link this kind of sympathetic nerve malfunction to other conditions. These include abnormal heartbeat patterns, poor blood flow to the legs, or sensitivity in the fingers due to low circulation.

Sympathectomy surgically halts overactivity in the nerves. The surgeon clamps off or severs the nerves responsible for the problem. If successful, the related body systems begin to function more normally.

Sympathectomy for Hyperhidrosis

To block off part of the nervous system bundle, a surgeon needs to go in through both sides of the chest. Patients receive a sympathectomy under general anesthetic.

• The surgeon first makes small incisions under the armpit on one side. This allows the first lung to be temporarily collapsed for better access to the nerve chain.
• The medical team then inserts a tiny camera called an endoscope. This imaging technique allows the team to locate the sympathetic nerve area controlling the patient’s medical issue.
• The problem area is then clamped or severed.
• After this, the lung is re-expanded and the incisions closed.
• The surgeon then repeats the same process on the other side.

Patients usually remain in the hospital for 24 hours following surgery. Overall recovery is about a week. During that time, most people can eat a normal diet and perform light activities. The main priorities are keeping the incisions clean and avoiding overexertion. Most patients will be cleared for return to work and other regular activities by the end of the week.

Possible Risks and Complications: Sympathectomy Side Effects

The surgery is not without potential consequences. The same risks that apply to all surgeries extend to a sympathectomy.

• Bleeding, infection, stroke, and severe reactions to the anesthesia can occur.
• There can also be complications related to collapsing both lungs.
• Longer-term, some people who undergo sympathectomy report chest pains from the endoscope.
• Breathing may also bring pain, at least in the first two weeks.
• Men may develop fertility issues related to semen ejaculating into the bladder.

Sympathectomy involves cutting into a complex nerve bundle. That's why the risk of unanticipated nerve damage needs to be considered. Some people experience drooping eyelids and vision problems from nerve damage. Others find that sweat glands in other areas actually increase their production. Additional nerve damage problems can include burning or weakness in the arms.

Of course, an obvious potential outcome of the surgery is it might not work. About 10% of patients with hyperhidrosis don’t find relief after surgery.

Sympathectomy Alternatives

It’s important to remember that surgery is the last resort for many conditions, including hyperhidrosis and RSD. Less aggressive options include medication and injections. Holistic methods can also address many of the most uncomfortable or embarrassing symptoms. These are applicable provided there is an early diagnosis.

• Prescription antiperspirant for hyperhidrosis. This antiperspirant is stronger than drugstore versions. It can also help control sweating in several areas, not just the underarms. The deodorant goes on at night for deep absorption, with the residue washed off in the morning.
• Botox injections and nerve-blocking oral medication. Each method short-circuits malfunctioning nerves. Medications are usually taken daily. Botox injections into the sweat glands occur once or twice a year.
• Outpatient procedures. If excessive sweating under the arms is the issue, doctors can insert a curettage tool and suction out sweat glands. A device using microwave energy targets sweat glands in other problem areas.

Home Treatments for Hyperhidrosis

Still, looking for a more natural solution? Consider some common-sense strategies for hyperhidrosis.

• Make sure your clothes and bedding are all made of natural fibers, to both control and wick away sweat.
• Some people achieve success by applying tannic acid toners -- or even brewed tea  -- to problem areas.
• Witch hazel is another method for treating overactive sweat glands.
• Stress can trigger excessive sweating or the discomfort associated with RSD. Devote time to calming activities. Yoga, massage, and meditation are time-honored solutions to racing minds and nervous energy.
• Basic cardio activities can also release mood-boosting endorphins. And don’t overlook the power of taking a walk in the fresh air!

Biofeedback Treatment
Some nervous system responses can stem from "crossed wires." The body feels excessive stress or pain, without a logical medical reason. Biofeedback treatment can be useful in these cases. The therapeutic technique helps your brain process biological information more accurately. For example, RDS patients often feel pain when there’s no immediate cause. People with hyperhidrosis break out into sweat over minor stressors. By using simple biofeedback devices, technicians help patients retrain their minds and bodies. Over time, patients stop associating harmless outside stimuli with pain or danger.

Mirror Therapy
Mirror therapy is another holistic RSD technique. In these sessions, patients perform simple functions in a mirror using their “good” limb. The mirror tricks the brain into seeing the “bad” limb doing these actions. Of course, the patient doesn't feel pain while doing it. This method allows the patient to stop expecting pain when using the affected limb.

Check out this video from Search Herbal Remedy for 9 natural remedies for excessive sweating:

While sympathectomy is a medically approved option, home management is highly recommended. If you have hyperhidrosis, reassess certain lifestyle habits. Lotions and moisturizers should be water-based so that your skin is able to breathe. Consider changing your diet so that your body doesn’t need to “sweat out” toxins. Too much meat and alcohol can produce sweating in many people, for example. Many patients have found relief through outpatient procedures and holistic alternatives to sympathectomy.

Would you give sympathectomy a try? Share your insights with us in the comments below!

Up Next: What Is RSD Treatment Protocol? | Reflex Sympathetic Dystrophy