The lumbar sympathetic nerve block is a procedure to block or reduce pain in the sympathetic nervous system. Sympathetic nerves control different bodily functions and are the group of nerves on the front side of the spinal cord. An injury to the lower extremities can cause pain even after healing.
Common conditions include Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD) with symptoms ranging from burning pain to swelling. The procedure involves an anaesthetic injection near the spin to block the sympathetic nerves in that region, thereby reducing any pain experienced.
If the block provides pain relief, a series of blocks will be performed to break the pain cycle and give you long term pain relief. The number of procedures performed depends on how long the pain relief lasts between each injection. Your doctor will be able to provide more detailed information about the procedure.
The lumbar sympathetic nerve block is performed in our CT scan room. You will be connected to monitoring equipment including an EKG monitor, blood pressure cuffs, and a device to monitor blood-oxygen levels for safety purposes. You will then be positioned on your stomach on a table.
An intravenous line may be started by the doctor or nurse to help you relax if necessary. The skin on your back will be properly cleansed with antiseptic and alcohol prior to injection of local anaesthetic near the sympathetic nerves. Patients can expect to feel a mild burning sensation for several seconds.
Once the anaesthetic takes effect, another needle is inserted with guidance from a CT scanner. A mixture of long acting anaesthetic and anti-inflammatory medicine (cortisone) is then injected. You will stay in our recovery area while we continue to monitor your vitals until the doctor feels it is appropriate for you to leave the clinic.
It is not necessary to be asleep during the procedure although patients will be given enough medication to be comfortable. Lumbar sympathetic blocks typically take between 10 to 15 minutes to complete.
Prior to the procedure
It is strongly recommended that you avoid eating any meals within four to five hours before the procedure as you will be receiving medication. Diabetics are advised to not take any medications until after the procedure. You may be asked to stop taking certain medications such as blood thinners for several days. Be sure to discuss the details with your doctor.
After the procedure
Refrain from any physical activities that require coordination as you may experience numbness in your leg a few hours after the procedure. Patients are advised not to operate a motor vehicle for the remainder of the day. You may be able to resume normal activities the day after depending on how you feel.
It is important to continue with physical therapy if it is prescribed by your doctor. The numbing medicine may provide immediate relief although there is a possibility the pain may return within a few hours. The steroid medication may take a few days to take effect.
Complications from the lumbar sympathetic nerve block procedure are rare but can include allergic reactions to the medication, nerve damage, injection into a blood vessel or infection at the injection site. If you have any medical conditions or taking any medications, please let your doctor know immediately.
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Painsense specialises in providing interventional pain management services to patients in our clinic. Contact us today to schedule an appointment or if you have any questions about this procedure.