The lumbar sympathetic nerve block is a procedure used to block or decrease pain in the lower extremities caused by injury or disease of the sympathetic nervous system.

The lumbar sympathetic nerves are located on either side of the lumbar spine (lower back). After an injury or illness, the sympathetic nervous system may not function properly, causing pain. Some of the more common conditions include complex regional pain syndrome (CRPS) also known as reflex sympathetic dystrophy (RSD), sympathetic maintained pain and herpes zoster (shingles) involving the lower part of the body.

If the block relieves your pain, the doctor will then perform a series of blocks, in an attempt to break the pain cycle and provide long lasting pain relief. The number of blocks you will need depends on how long the pain relief lasted between injections. Usually you will get longer pain relief after each injection and the frequency of blocks will decrease.

Procedure Overview

The lumbar sympathetic block is an outpatient procedure done in our facility’s ambulatory surgery center under strict sterile conditions. For your safety and comfort, you will be connected to monitoring equipment (EKG monitor, blood pressure cuff, and a blood-oxygen monitoring device), and positioned on your stomach. The doctor or nurse may start an intravenous line and give some medicine to help you relax. Your back is cleansed with an antiseptic soap after which the doctor injects numbing medicine deep into your skin and tissue. This will cause a burning sensation for a few seconds.

After the numbing medicine takes effect, the doctor will insert another needle and, with the assistance of a special X-ray machine called a fluoroscope, the doctor will inject a radiopaque dye (contrast solution) to ensure the needle is in proper position. With the needle in position, a small mixture of numbing medicine (anesthetic) and anti-inflammatory medicine (steroid) is injected. After the procedure, we ask that you remain at our facility until the doctor feels you are ready to leave.

After the Procedure

You may experience some warmth in your legs a few hours after the procedure. Depending on how you feel, you may resume normal activities and return to work the following day. If the doctor prescribes physical therapy, it is very important that you continue with the physical therapy program. Although you may feel much better immediately after the injection (due to the numbing medicine), there is a possibility your pain may return within a few hours.

Watch this short video below to learn more about the procedure.