What is a lumbar sympathetic block?

A lumbar sympathetic block is an injection of anesthetic and occasionally steroid medication into the sympathetic nerves. These nerves are located in the lower back on both sides of the spine. This procedure is done to alleviate chronic pain in the lower extremities.

Lumbar Sympathetic Block Procedure

The total procedure time, beginning with patient prep and ending with recovery, is about one hour. Because it is an out-patient procedure, lumbar sympathetic injections are most often performed at a pain clinic.

To begin, the patient will lay face-down on the table. A doctor will clean the injection site with antiseptic solution. He or she will then inject a local anesthetic to prevent pain during the procedure. The patient may feel a pinch or slight pressure during this injection. Next, using x-ray guidance, the doctor will guide a needle into the proper position along the spine. A contrast dye is injected to confirm accurate placement. Then, the mixture of anesthetic and pain medication is injected. Upon completion, the patient will be monitored for a brief period.

What are the side effects?

There are very few risks associated with lumbar sympathetic injections. Immediately following the procedure, patients may report weakness or numbness of the legs and lower back, a feeling of warmth at the injection site, or increased pain. These sensations are likely a result of the local anesthetic and tend to subside within a day. More severe complications include nerve damage, infection and bleeding. Call your doctor if you have any concerns.

How long does it take for a sympathetic nerve block to work?

Patients may experience immediate pain relief as a result of the local anesthetic used during the procedure. The nerve block typically takes affect in the following hours. 

How long does a lumbar sympathetic block last?

Pain relief varies for every patient. Some may experience symptom relief for a few hours, while others a few days. Patient’s who receive a greater number of injections are likely to have prolonged relief. If the first sympathetic nerve block was successful, repeated procedures may be a good option for pain management.