Lumbar Sympathetic Block
The lumbar sympathetic block procedure is administered to patients who are suffering from pain stemming from the sympathetic nervous system. Located in the lower back on each side of the spine, pain and inflammation in the lumbar region can become persistent and painful and cause persistent or chronic leg and limb pain.
A physician may recommend a series of sympathetic block injections to alleviate the soreness and inflammation in these affected areas. The treatment is designed to block the pain signals that travel to the brain via the sympathetic nerve, allowing many patients to experience tremendous pain relief. Lumbar sympathetic blocks are commonly used to treat conditions including:
- Peripheral neuropathy
- Vascular insufficiency
- Reflex sympathetic dystrophy
- Herpes zoster infection of the legs (shingles)
- Complex regional pain syndrome
About the Lumbar Sympathetic Block Procedure
This procedure typically lasts anywhere from 15 minutes to half an hour but may take longer in certain situations.
1. Before the procedure begins, patients will be administered a local anesthesia intravenously to promote relaxation. Vital signs may also be monitored throughout the procedure to ensure the patient remains calm and relaxed.
2. Patients will be asked to lie on their side or stomach atop a fluoroscopic table that serves as an x-ray unit. A nurse or physician will then apply a local anesthetic to the injection site to numb the skin and tissue of the sympathetic nerves to minimize any pain from the procedure.
3. A contrast dye is injected at the target site along the spine. Using the fluoroscope table, the physician will examine the x-ray to confirm that the needle is injected into the correct region where the pain is occurring.
4. Next, the medication is injected near the affected sympathetic nerves, blocking the pain signals from traveling to the brain. This solution is typically comprised of an anesthetic, an anti-inflammatory steroidal medication, and saline.
5. This procedure may leave patients with numbness and weakness in the legs for several hours post-injection and are advised against driving and strenuous tasks for at least 24 hours. Most patients may resume work and normal activities the following day after a lumbar block procedure.
Efficacy of Lumbar Sympathetic Blocks
Pain relief may immediately follow a lumbar sympathetic block and then return in a few hours once the anesthesia has lost its effect. However, lasting relief typically commences within a few days as the steroid begins to work. Depending on the efficacy of the procedure, a physician may recommend weekly or regularly scheduled injections to control the pain. Patients may require anywhere from two to 10 injections in order for the pain to completely subside.
Risks Associated with a Lumbar Sympathetic Block
The risks associated with this procedure are very minimal. The most common side effects are soreness or bruising at the site of the injection. Other complications including bleeding and infection are rare. However, those taking blood thinners may be asked to temporarily cease such medications or be guided to another form of pain control besides a lumbar block procedure. A physician will discuss any additional risks to each patient before the procedure.
Is a Lumbar Sympathetic Block Right for You?