Lumbar Sympathetic Nerve Block

A lumbar sympathetic nerve block is a procedure used to block or decrease pain in the lower extremities. The lumbar sympathetic nerves are located on either side of the vertebral bodies of the spine and control the involuntary functions of the body, such as temperature regulation to the arms and legs, sweating, heart rate, digestion and blood pressure. After an injury or illness, the sympathetic nervous system may not function properly, causing pain. One of the more common conditions treated is Complex Regional Pain Syndrome (CRPS) involving the lower part of the body.

You will need a ride home. No driving for 3 hours after the procedure due to the side effects of medications given.

When you arrive, a nurse will get a description of your pain and how you are managing daily activities. Your blood pressure, pulse, temperature and weight will be taken. Medications, allergies and a brief health history will be reviewed. It is important to let the nurse know if you have allergies to X-ray dye, Betadine or latex, if you are taking blood thinners, such as Coumadin, Plavix, Pradaxa or Lovenox, if you have diabetes or if you might be pregnant.

An IV lock may also be started in your arm. Temperature strips will be applied to the tops of your feet as this can be a helpful indicator of a successful block.

After discussing treatment with your physician and signing consent forms, you will go the X-ray room where you will be helped onto the X-ray table into the best position for visualizing your spine. We will try to make you as comfortable as possible. Your skin will be cleaned with antiseptic and after numbing the skin on your back, the physician will place a needle near the sympathetic nerve branch using X-ray guidance. A small amount of contrast dye may be injected to confirm the proper placement of the needle and a steroid mixture will be injected. The entire procedure will take less than a couple minutes.

You should plan to stay for about 30 to 45 minutes after your procedure while we monitor your response to the procedure. A nurse will be available to answer any questions you might have and review instructions and follow-up care.

When you go home

  • Activities: You can resume activities but avoid those that might make your pain worse. You can usually return to work the next day and begin exercising on the second day.
  • Pain: Ice on the injection site and taking your pain medications will help with any discomfort. Some patients might feel more pain after the injection because the steroid can be irritating to the nerves. You should notice an improvement in three to seven days.
  • Follow-up: This procedure may be repeated weekly as prescribed by your physician.

You may experience pain relief and warmth in the affected hand or foot for four to 18 hours. Many patients will have diminished pain after the several injections as the sympathetic system returns to normal.

 

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