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Elaboration on Lumbar Sympathetic blocks

What is a Lumbar Sympathetic Block?

“A lumbar Sympathetic Block” is an injection of local anesthetic into or around the sympathetic nerves. These nerves are a part of the sympathetic nervous system. The nerves are located on either side of the spine, in the lower back. Normally these nerves are responsible for the controlling of basic functions like regulating blood flow.

What is the purpose of Lumbar Sympathetic Block?

The reason to perform this is to block the sympathetic nerves that go to the leg on the same side as the injection. The result is reduction in pain, swelling, color, sweating and other changes in the lower extremity. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome and Herpes Zoster (shingles) involving the legs. Patients with neuropathy or peripheral vascular disease may also benefit from lumbar sympathetic blocks.


The target of this procedure is a small space just in front of the vertebral bodies of the lumbar spine where the sympathetic lie. A small thin needle is inserted and guided towards the ganglion. A small amount of local anesthetic is injected, once the needle tip is in the proper position adjacent to the sympathetic ganglion. When the injection is complete, a small dressing will be placed and your physician or specialist will gauge the after effects of the treatment. Pain relief will surely follow after experiencing a warm sensation on the side of the leg where the procedure was performed.

What should one expect after?

After a successful blockade of the sympathetic nervous system there will be an increase in the skin temperature. That is; a warmth sensation felt over the leg where the treatment took place. After the procedure is completed there are several possible outcomes:

  1. After the anesthetic effect is worn off, the pain is improved or even eliminated for several days. This describes an obvious therapeutic value for the procedure as well as an insight as to the process causing pain and guiding the future treatment plan to maximize the pain control.
  2. The warm sensation in the leg depicts a successful sympathetic blockade; however there is no pain relief. This means that the block was successful and the lack of pain relief will be diagnostic value to your doctor. This will help guide your physician/specialist while coming up with the future treatment plans.
  3. There is no sensation of warmth in the leg and there is no pain relief. This is a clear sign that the blockade was not performed correctly. And it may be required to repeat the process properly to see whether or not the pain the pain is driven by sympathetic nervous system. 

The merits of this procedure include

  • It is a minimally invasive treatment with the potential of relieving pain where other conventional therapies have failed.
  • The injection has the ability to offer immediate pain relief by allowing the patients to participate in physical therapy and return to their normal daily activities.
  • It can also be used to treat and diagnose variety of pains that are non responsive to conventional therapies.
  • The procedure is used in the treatment of CRPS, phantom limb pain, post herpetic neuralgia, ischemic limb pain and cancer pain.

If you are suffering from chronic pain that has failed to respond to treatment and would like to see if you may be a candidate for a Lumbar Sympathetic block, contact our Pain Management Institute today.