A lumbar sympathetic block is an injection into or around the sympathetic nerves. These nerves can carry pain information from the peripheral tissues back to the spinal cord. Lumbar sympathetic blocks work well for lower extremity pain from reflex sympathetic dystrophy, complex regional pain syndrome, phantom limb pain, shingles, cancer pain, vasospastic disorder, and inoperable peripheral vascular disease. The procedure is done under fluoroscopy, which assists in positioning the needle on the side of the lumbar sympathetic chain, contrast dye is injected to confirm accuracy. The local anesthetic is administered, sometimes along with a steroid, to provide longer lasting symptom relief.
Often relief due to the anesthetic is felt immediately with temporary weakness or numbness in the leg. Pain relief from the anti-inflammatory steroid medications will typically occur within several days to two weeks. This procedure may be repeated several times in order to improve and increase pain relief.
Generally, 20 minutes for the procedure with 15-20 minutes of observatory recovery time.
If local anesthetics are used, we advise you not to drive for at least 12 hours. If sedation is used, you should not drive or operate heavy machinery for 24 hours. By the next day, previous activities may be resumed unless there are complications. Despite improvement, you are cautioned against engaging in strenuous activities. A gradual increase in activities is advised.
The most common side effect is pain and soreness at the injection site. Uncommon risks include bleeding, infection, and backache. Fortunately, serious side effects and complications are uncommon.