Conservative care & rehabilitation (non-surgical procedures)

Lumbar Sympathetic Block

A Lumbar Sympathetic Block is a Pain Management procedure used to treat the pain carried by sympathetic nerves. Sympathetic nerves can be found in your lower back on the either side of your spine. These nerves typically control basic functions like regulating blood flow. In certain conditions, they can carry pain information from the peripheral tissues back to the spinal cord. Refer to the top illustration.

A Lumbar Sympathetic Block treatment addresses this condition through an injection of local anesthetic to the sympathetic nerves. Your back doctor performs this procedure to block the sympathetic nerves that go to your leg on one side. This treatment can reduce pain and swelling in your lower extremity. It also may improve mobility.

OVERVIEW

This procedure helps relieve leg pain caused by complex regional pain syndromes, which may develop after an injury to one of your joints or limbs. You normally require a series of injections to treat this problem. The procedure is described below. Talk to your doctor about the risks and what to expect during the procedure.

1. PREPARING FOR THE PROCEDURE

You must lie on an X-ray table, either on your side or on your stomach. Your doctor connects an intravenous (IV) line to you to administer medication that relaxes you. A local anesthetic numbs the skin and tissue down to the sympathetic nerves, as shown in illustration 1.

2. INJECTING THE CONTRAST DYE

Your physician uses a fluoroscope to guide a needle through the anesthetized track. Your doctor then injects a contrast solution, which shows up easily on the fluoroscope, so he or she can identify the painful areas and confirm the correct location of the needle tip. See illustration 2.

3. INJECTING THE MEDICATION

Next, as shown in illustration 3, the doctor injects a mixture of anesthetic, saline and anti-inflammatory medicine around the sympathetic nerves. These drugs work to block the pain signals from reaching your brain.

4. RECOVERING FROM THE PROCEDURE

Once your doctor removes the needle, the he or she applies a small bandage to the surface wound. Your legs may feel weak or numb for a few hours after the procedure. By then, you should feel less pain in your legs.

You may repeat this procedure about once a week until your pain subsides. If you are on blood-thinning medication or if you have an infection near the injection site, you should not receive a Lumbar Sympathetic Block.