A lumbar sympathetic nerve block is administered to both diagnose and treat pain in the lower extremities from abnormally acting nerves.
It is used to determine whether the lumbar sympathetic nerves, which carry pain impulses from the lower extremities, are the cause of the pain, and, in some cases, serves to eliminate that pain altogether. During the procedure, medication is injected into or around the lumbar sympathetic nerves on one side of the body.
Underlying conditions for which a lumbar sympathetic block may be considered include the following:
- Complex regional pain syndrome
- Herpes zoster (shingles)
- Peripheral vascular disease
When successful, the injections reduce pain, inflammation, abnormal skin color and sweating, and improve the patient‘s mobility.
Lumbar Sympathetic Nerve Block Procedure
Receiving a lumbar sympathetic block injection is done in the office under fluoroscopy and with the use of radiographic dye or contrast in order to precisely place the injected local anesthetic on the lumbar sympathetic nerves. The skin is numbed with a small needle and local anesthetic at the entry site which is in the lower back with the patient lying facedown. Monitors are applied to the skin to assess the temperature of the skin as it will often increase after the injection for a short period of time. The injections can provide long-term relief but sometimes only short-term relief is realized. They can be repeated and coupled with intensive physical therapy of the extremity to improve pain control and function.
Risks of a Lumbar Sympathetic Nerve Block
Although receiving a lumbar sympathetic nerve block is a safe, there is a risk of complications, which includes infection at the injection site, nerve damage, bleeding, or leakage of spinal fluid.
Recovery from a Lumbar Sympathetic Nerve Block
After a lumbar sympathetic nerve block procedure, a patient usually returns home after a few hours, and is able to return to work the next day. The effectiveness of a lumbar sympathetic nerve block varies. Some patients experience permanent relief, whereas others experience relief for only a few weeks or months, and require additional treatment.
If the block relieves the patient‘s pain, a series of injections may be administered to provide long-lasting relief. If the block does not relieve pain, radiofrequency ablation may be considered.