The lumbar, or lower back, sympathetic plexus is a collection of nerves that carries sympathetic nerves to the lower extremities. Sympathetic nerves control bodily functions such as sweating, heart rate, blood vessels, pupil dilatation, movement of food through the intestines, and more. A lumbar sympathetic block is a pain relief procedure that is performed to relieve leg pain caused by complex regional pain syndromes, which may develop after an injury to a joint or limb.
How is Lumbar Sympathetic Block Performed?
Patients lie either on their side or stomach on a table equipped with a live x-ray, or fluoroscope. An intravenous line is started to administer medication to relax the patient and a local anesthetic numbs the skin and tissue down to the sympathetic nerves. Then, a needle is inserted to inject contrast solution to correctly position the needle and accurately identify the pain areas. A mixture of anesthetic, saline and anti-inflammatory medicine is injected to the sympathetic nerves to block pain signals from reaching the brain.
What should be expected?
The legs may feel weak or numb for a few hours after the procedure. More blocks may be repeated about once a week until the pain subsides. Patients who are on blood-thinning medications or who have an infection near the injection site should not receive the block.
A lumbar sympathetic nerve block may benefit certain conditions where vasodilation (which is the widening of blood vessels) or where pain affects the sympathetic nerves. Vasodilation helps relieve lower extremity pain caused by ischemia; a restriction of blood supply or flow. If the nerve block proves helpful, neurolysis can block pain, or spinal cord stimulation may be recommended. Neurolysis utilizes a chemical or other method to disable the nerve’s ability to transmit pain signals to the brain.
Extremity pain conditions, such as Reflex Sympathetic Dystrophy (RSD) and Complex Regional Pain Syndrome (CRPS) may benefit from this procedure. Local anesthetic is commonly used to, which is effective for several hours. Although the local anesthetic provides short term pain relief, the nerve block may provide relief from chronic pain for days to weeks. A lumbar sympathetic block can help clarify an unclear diagnosis of RSD/CRPS. If the nerve block provides long term pain relief, it can be repeated.
If you need an evaluation or consultation or are interested in Lumbar Sympathetic Block, please contact us at (201) 729-0001 and ask for one of our specialists. Our conveniently located clinics are in West Orange, Aberdeen, Lyndhurst, and Fort Lee. We offer weekday and weekend appointments.