A Lumbar Sympathetic block is an injection of numbing medicine to the sympathetic nerves that go down your legs. The injection is in the low back outside of your spinal cord.
WHAT IS THE PURPOSE OF IT?
The Lumbar Sympathetic block numbs the sympathetic nerves of the legs. This may help reduce pain, swelling, color and sweating changes. This injection is utilized to help treat CRPS (complex regional pain syndrome) RSD (reflex sympathetic dystrophy) or any type of sympathetically mediated pain of the lower extremities.
HOW LONG DOES THE INJECTION TAKE?
The actual injection only takes a few minutes. You can expect to be in the procedure room for about 15 minutes for positioning, placing monitors, preparation, and the procedure.
What is actually injected?
A local anesthetic (numbing medicine) is injected. There may be one or two other types of medicine added to help prolong the block.
Will the injection hurt?
Most patients tolerate the injection very well. Numbing medicine is placed under the skin that feels like a poke and a burn. After that, you most likely will only feel pressure. If you feel any pain during the injection, more numbing medicine can be given. If you choose, you may have intravenous sedation to help you relax.
How is the injection performed?
You will be lying on your stomach on an x-ray table. We will monitor your blood pressure, heart rhythm, and blood oxygen. Your skin will be cleansed with an antiseptic. After the injection, you will be placed on a bed and moved to the recovery area.
Will I be "put out" for this procedure?
No. The safest way to do this procedure is under local anesthesia. You may choose to have intravenous sedation, which will help you relax, but you will always be awake during the procedure to minimize the chance of any nerve damage.
What should I expect after the injection?
After the injection, you may notice that your pain has lessened. Your leg may start to feel warm or may start to appear red. You may notice some changes in sweating or sensation.
What should I do after the procedure?
You will always have someone to drive you the day of the injection. Some of the patients may go for immediate physical therapy. Otherwise, you will perform activity as tolerated Can I go to work to work the next day? You should be able to return to work the next day unless otherwise directed by your physician. Some patients will feel soreness in the back at the injection site.
How long will the effect of the medication last?
The numbing medicine will wear off after several hours. The block of the sympathetic nerves may last much longer than that. A series of injections is usually required for treatment with a progressive increase in relief with each injection.
How many injections do I need?
Usually a series of injections will be needed for treatment if you respond to the first injection. You should be obtaining progressive benefit from the injections as well as physical therapy. Some patients may require over 10 injections where others will require fewer.
Side Effects | Risks
Overall, the procedure is very safe. As with any procedure, there are risks. The most common side effect is pain, which is temporary. Any time a needle is punctured through the skin, there is a chance of bleeding or infection that is very rare. Other rare side effects include spinal headache, nerve damage, worsening of pain, etc., which are extremely unlikely.
Who should not have these injections?
If you are allergic to specific local anesthetics or ionic contrast, please notify your physician. Also, if you are taking any blood thinners (Coumadin, Plavix, Warfarin, Lovenox, Aspirin, etc,) please let your physician know ahead of time to help devise a safe plan for the injection.