FAQ’s on Lumbar Sympathetic Block
Persistent low back pain may need therapeutic intervention. Up to 45% of patients have had success in alleviating back pain symptoms by way of a therapeutic “block,” or interruption of pain signals, reports the International Association for the Study of Pain.
What is a lumbar sympathetic block?
Our team may recommend a lumbar sympathetic block. This is a therapeutic injection, or series of injections, of a mixture of local anesthetic often combined with a corticosteroid or drugs like epinephrine or clonidine in the area in and around the sympathetic nerves intended to relieve leg pain caused by any of a number of reasons, such as a condition or disease (Are sympathetic blocks useful for diagnostic purposes?2013).
What conditions are treatable with lumbar sympathetic block?
- Complex Regional Pain Syndrome (Computed tomography guided lumbarsympathetic block for complex regional pain syndrome in a child: a case report and review 2006)
- Some forms of neuropathy or peripheral vascular disease
- Reflex Sympathetic Dystrophy (RSD)
- Herpes Zoster (shingles) affecting the legs
- Sympathetic Maintained Pain (Diagnostic nerve blocks in chronic pain.2003) (Lumbarsympathetic block for sympathetically maintained pain: changes in cutaneous temperatures and pain perception. 2003)
What are expectations when a patient receives lumbar sympathetic nerve block treatment?
Patients who receive the sympathetic lumbar nerve block procedure can expect to experience a relief from leg pain caused by the aforementioned conditions. They may also expect to experience a reduction in swelling, sweating, and experience an improvement in flesh color, mobility, and blood flow to the affected limb or limbs.
How is a lumbar sympathetic nerve block treatment performed?
The patient lies on their stomach and is monitored with an EKG, blood pressure cuff and 02 monitor. Occasionally they will have temperature probes on their feet. Under sterile conditions the skin in the injection area is cleaned and anesthetized with a local anesthetic. Then with the aid of a fluoroscope (a type of x-ray machine), the physician first injects a test dye to insure the drug will be injected in the correct location. When this is confirmed the drugs are slowly injected over several minutes, at this point the patient may feel pressure or even a slight discomfort. When the appropriate amounts of medications have been injected the needle is removed and the injection site is simply covered with a band-aid. Many patients will experience nearly immediate results, often due to the local anesthetic alone. Many patients will require several injections to gain the maximum effect from the procedure (Complex regional pain syndrome type I following discTRODE radiofrequency treated with continuous lumbarsympathetic trunk block using patient-controlled analgesia 2013).
How long does lumbar sympathetic nerve block treatment last?
The duration of the effects of the lumbar sympathetic nerve block treatment can vary from patient to patient. Most will experience immediate relief on some level. Full relief may or may not occur after multiple treatments. The number of treatments required will vary from patient to patient as well, depending upon the severity of their condition (Intractable erythromelalgia of the lower extremities successfully treated with lumbarsympathetic block 2013.).
Diagnosis by your physician will determine the best treatment path for each individual. Once the full effect has been reached they may last for anywhere from several weeks up to several months. Some patients may experience relief continuously with follow up visits for the treatment.
What risk or side effects are possible with lumbar sympathetic nerve block treatment?
As with any medical procedure there is always a possibility of some level of side effect. For the most part these side effects will be inflammation, bruising, mild bleeding, and swelling in the injection site. Often the patient may experience discomfort or pain at the beginning of the procedure until the medications begin to take effect. Less common, but more serious side effects can be infection and tissue or nerve damage in the injection site, although this is very rare.