What is a Lumbar Sympathetic Block?
Lumbar sympathetic blocks are the injection of local anesthetic around the nerves of the sympathetic nervous system found on either side of the spine, in the lower back. Lumbar sympathetic blocks may help to reduce pain, swelling, discoloration and/or sweating changes and may improve mobility in the lower extremities. Lumbar sympathetic blocks may be useful in the treatment of reflex sympathetic dystrophy (RSD), complex regional pain syndrome (CRPS) and herpes zoster (shingles) involving the lower extremities.
Lumbar sympathetic blocks are performed in the office. Patients are required to check in 30 minutes prior to their scheduled appointment time. Once taken back to the preparation area, a small IV catheter will be placed in your hand or arm. This catheter may be used to administer light sedation for the procedure. When taken to the procedure room, you will be placed on your stomach with a pillow under your hips. Blood pressure and oxygen saturation monitors will be applied. The injection sites will be cleansed with an antiseptic solution and draped in a sterile manner. Using a small, thin needle, local anesthetic is injected to numb the skin and deep tissue, which may feel like a stinging and/or burning sensation. Assisted by fluoroscopy (X-ray), the physician is able to correctly place the needle and inject local anesthetic around the sympathetic nerves. You may experience a pressure sensation as the medication is injected. Following the procedure, you may feel a warm sensation in your lower extremities and an absence or decrease in pain. You may also experience weakness or numbness in the leg, which is temporary. The procedure will take approximately 15-30 minutes to complete. If you respond well to the first injection, a series of additional injections may be indicated.
The local anesthetic used for the lumbar sympathetic block will wear off in a few hours. However, the sympathetic block may last longer and will generally increase after each injection. You may experience “soreness” of the injection site for 1-3 days following your procedure. We advise patients to “take it easy” for the remainder of the day. You may perform activities as tolerated.
Once the procedure is over, you will be taken to a recovery area, where you will be monitored for 15-30 minutes and released to go home. You MUST have someone available to drive you home. Failure to have a driver may result in your procedure being rescheduled. You should be able to return to work the next day.
Lumbar sympathetic blocks are commonly performed procedures. Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to follow when other conservative therapies have failed to produce improvement. Possible side effects may include infection, bleeding, hematoma, pain at the injections site, headache and temporary increase in pain. You may feel lightheaded and/or unsteady; this is usually due to the sedation you were given during the procedure.