Lower back pain management using Lumbar Sympathetic Block

What is a Lumbar Sympathetic Block?

A lumbar sympathetic block is an injection of local anesthetic into or around the sympathetic nerves. These sympathetic nerves are a part of the sympathetic nervous system. The nerves are located on the either side of spine, in the lower back. Normally these nerves control basic functions like regulating blood flow. In certain conditions, these sympathetic nerves can carry pain information from the peripheral tissues back to the spinal cord.

What is the purpose of a Lumbar Sympathetic Block?

A lumbar sympathetic block is performed to “block” the sympathetic nerves that go to the leg on the same side as the injection. This may in turn reduce pain, swelling, color, sweating and may improve mobility. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome and Herpes Zoster (shingles) involving the legs. Certain patients with neuropathy or peripheral vascular disease may also benefit from lumbar sympathetic blocks.

How is the Lumbar Sympathetic Block?

This procedure is done under local anesthesia, which makes the procedure easy to tolerate. It is done with the patient lying on stomach. The patients are monitored with EKG, blood pressure cuff and an oxygen-monitoring device. Temperature sensing probes may also be placed on your feet. The lumbar sympathetic block is performed under sterile conditions. The skin on back is cleaned with antiseptic solution and the skin is then numbed with a local anesthetic. Then X-ray is used to guide the needle or needles into the proper position along the outside of the spine. Once in place, a test dose of dye is used to confirm that the injected medication will spread in an appropriate area. If this is okay, the injection takes place gradually over several minutes. The physician will use the X-ray to evaluate the spread of the injected medication. When a sufficient area is covered, the injection will be over. When done, the needle is removed and a Band Aid is applied.

What should I expect after the Lumbar Sympathetic Block?

Immediately after the injection, you may feel your lower extremity getting warm. In addition, you may notice that your pain may be gone or quite less. You may also notice some temporary weakness or numbness in the leg, although this is actually not a desired effect of a lumbar sympathetic block.

Please note that you will be unable to drive for 24 hours after your procedure.

Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness in the back at the injection site.

In the case of numbness, which has not gone away after 24 hours or any loss of control over bladder or bowel, you should contact Pain Matrix or attend your local Emergency Department.