Overview of Treatment
The sympathetic nerves are the part of the autonomic nervous system that constricts blood flow and increases your heart rate, blood pressure, and perspirations.
These nerves can also transmit pain following an injury to trauma to the surrounding nerves, tendons, ligaments, and bones. The sympathetic nerves sometimes become unnecessarily stimulated, which causes the constriction of blood vessels and poor circulation in your limbs. When the sympathetic nerves surrounding the lumbar spine become unnecessarily stimulated, they can cause mild to severe leg and foot pain.
Lumbar sympathetic blocks are a minimally invasive outpatient treatment option that relieves chronic leg and foot pain by injecting steroids into the sympathetic nerves located on the front side of the spine. These blocks can function as a diagnostic tool for chronic lumbar pain.
Conditions treated
Lumbar sympathetic blocks reduce chronic pain caused by
- Complex regional pain syndrome
- Reflex sympathetic dystrophy
- Vascular insufficiency
- Shingles
- Neuropathy
- Phantom limb pain
- Lower limb painful ischemia
- Cancer pain
- Raynaud’s syndrome
- Excessive sweating
- Spasms in blood vessels
Benefits
- Pain relief
- Assists in diagnosis process
- Short recovery period
- Non-surgical option for pain relief
Procedure
Before your procedure, your Arizona lumbar sympathetic block provider may ask you to stop taking non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppressant medication, and blood thinners to reduce your risk of serious complications or infections. If you are pregnant or suspect you are pregnant, talk to your doctor about alternative treatment options. Your healthcare professional may ask you not to eat or drink several hours before the procedure. This procedure cannot be performed if the patient has an active infection or symptoms of a cold, flu, or similar malady. If you experience these symptoms on the day of the procedure, you will need to reschedule your nerve block.
Your healthcare professional will ask you to lie face down on an x-ray table and administer a low-grade sedative to help you relax. They will then sanitize your back before injecting a local anesthetic into the lumbar sympathetic ganglia located at the back of the spine. Using x-ray guidance and contrast dye, your healthcare professional will inject the medicine into the proper location. If the lumbar sympathetic block is for therapeutic purposes, they will inject a corticosteroid. Diagnostic lumbar sympathetic blocks use a numbing medication or local anesthetic.
At The Pain Experts of Arizona lumbar sympathetic block procedures typically last less than thirty minutes. Once the medical practitioner completes the injection, you will remain in an observation room for about fifteen to thirty minutes to ensure no complications or immediate reactions occur. You must be able to walk without feeling weakness in your legs before you can return home. For most patients, this will happen in under an hour.
Recovery
Once discharged, you will be unable to drive or perform any rigorous activity for the remainder of the day. You will need someone else to drive you home from your procedure. You cannot take a bath or soak in water for three days after the injection. Your healthcare professional will recommend relaxing for the remainder of the day before returning to your normal activities.
You may experience an increase in lower back pain at the injection site, but this pain should dissipate within 48-72 hours. If the pain becomes intolerable, you can take over-the-counter pain medicine or apply an ice compress.
The onset of pain relief and its duration vary greatly among patients. Some patients report feeling immediate pain relief, while others feel relief after several days. Lumbar sympathetic blocks used for diagnostic reasons should provide pain relief within the same day, while therapeutic ones may take up to ten days to provide pain relief. Your pain relief may last several weeks or several months. If these nerve blocks successfully relieve your back pain, your healthcare professional may suggest adding periodic lumbar sympathetic blocks to your routine treatment regimen.
Risk
Lumbar sympathetic blocks are generally safe procedures, but there remains the possibility for compilations, such as:
- Infection, bleeding, or bruising at the injection site
- Allergic reaction to steroids or anesthesia
- Nerve damage
- Paralysis
- Sharp blood pressure decrease
- Anesthetic toxicity
- Blood in your urine
- Muscular numbness or weakness
Lumbar Sympathetic Block FAQs
Who is a good candidate for lumbar sympathetic block?
Patients experiencing chronic pain in the lower parts of their body, particularly in the legs, which does not respond to standard pain management techniques, may benefit from a lumbar sympathetic block. Conditions that often warrant this procedure include vascular insufficiency, reflex sympathetic dystrophy, herpes zoster infection (shingles), and neuropathic pain.
While many people with chronic pain can benefit from a lumbar sympathetic block, it might not be suitable for everyone. Patients with certain types of infections, those who are pregnant, or individuals with bleeding disorders should discuss their conditions with the doctor. A thorough medical evaluation will ensure that you are a good candidate for this treatment.
Is lumbar sympathetic block painful?
Because a local anesthetic is used, most patients only experience minimal discomfort during the procedure. You may feel slight pressure when the needle is inserted. Post-procedure, there might be some soreness in the injection area, but that usually subsides within a few days.
How long does the effect of the block last?
The duration of pain relief varies from patient to patient. Some may experience relief lasting from a few weeks to several months. In some cases, repeated sessions may be necessary to maintain the pain relief. Our team will schedule periodic appointments to ensure that you remain comfortable.
How often can I have a lumbar sympathetic block?
The frequency of lumbar sympathetic blocks depends on your response to the treatment and the chronic nature of your pain condition. Some patients achieve prolonged pain relief after just one injection, while others may require periodic treatments to maintain the benefits. Your pain specialist will discuss the best treatment plan for you based on your specific medical needs.
Can I resume normal activities after the procedure?
Patients are generally advised to take it easy for the rest of the day following the procedure. Normal activities can usually be resumed within 24 hours. It's essential to follow the specific post-procedure instructions provided by our doctors.
How do I prepare for a lumbar sympathetic block?
Before the procedure, you should inform your doctor of any medications you are taking, including blood thinners, as these might need to be adjusted. It's also recommended to avoid eating or drinking for several hours before the procedure. Arrange for someone to drive you home afterward, as you cannot drive for at least 24 hours due to the anesthesia.
Can a lumbar sympathetic block be used with other pain management strategies?
Yes, a lumbar sympathetic block can be part of a comprehensive pain management plan. It is often used in combination with physical therapy, medication, or other interventional procedures to achieve the best possible pain relief. Discuss with your pain specialist how this procedure fits into your overall pain management strategy.
Where can I get a lumbar sympathetic block?
The Pain Experts of Arizona offer this procedure at our facilities in Gilbert and Mesa. Our team of pain management specialists is highly experienced in performing lumbar sympathetic blocks, ensuring our patients' high level of care and safety.
For more detailed information or to schedule a consultation, please call 480-550-9393.
