A lumbar sympathetic block is an injection of steroid medication used to relieve lower back or leg pain, also called sciatica. Injecting a steroid medication and a local anesthetic into or around the sympathetic nerves can help alleviate pain in that area. Sympathetic nerves are positioned on both sides of the spine, in the lower back.
Benefits of a Lumbar Sympathetic Block
A lumbar sympathetic block can help treat the following conditions:
- Reflex sympathetic dystrophy
- Complex regional pain syndrome
- Vascular insufficiency
- Herpes zoster infection (shingles) involving the legs
- Peripheral neuropathy
- Raynaud’s syndrome
A lumbar sympathetic block can also help alleviate the following symptoms:
- Pain from spasms in blood vessels
- Chronic stomach pain
- Excessive sweating
Risks and Side Effects
The risks of a lumbar sympathetic block are very low. Some side effects may include bruising or soreness at the injection site. Serious complications such as infection and bleeding are rare.
Patients with lower back or low pain (especially pain linked to complex regional pain syndrome or reflex sympathetic dystrophy) who do not respond to other treatment may be good candidates for a lumbar sympathetic block.
The procedure cannot be performed if the patient has a cold, fever, high blood pressure, flu or an active infection. Patients who take blood thinners should let their doctors know to make sure the proper precautions are taken.
How to Prepare for Treatment
Patients are not allowed to consume any solid food or fluids after midnight prior to the procedure. However, patients may take medication with a small amount of water.
Individuals with diabetes should not take medication for the condition until the procedure is finished. Patients taking blood thinners such as Coumadin, Warfarin or Plavix will be required to stop taking them well before the procedure.
What to Expect During Treatment
Before the procedure can begin, the patient will be given intravenous medication to help them relax. The patient’s lower back will then be cleansed to help reduce the risk of infection. Next, the physician will use an x-ray to guide the insertion of the needle. The anesthetic and pain-relieving medication will be injected along the outside of the spine.
The entire procedure typically takes less than 30 minutes and patients are allowed to go home the same day. They will be monitored in the recovery room for a short period of time to ensure they are not experiencing any severe side effects. Patients are allowed to return home with their driver once the doctor authorizes discharge.
Patients typically need a series of injections to continue receiving pain relief; some may only need two injections, others may need more.
After the Procedure
Patients may have a strange sensation in their lower back and leg and may begin to feel less pain. The numbness or weak feeling will subside once the anesthetic wears off.
Patients should avoid driving or engaging in rigorous physical activity for 24 hours after the procedure. For maximum effectiveness, patients may need physical therapy and pain medicine.