A lumbar sympathetic block is an injection of local anesthetic into or around the sympathetic nerves.

Your sympathetic nerves run along the surface of your lower spinal column. They are a part of your autonomic nervous system that controls involuntary functions like the flow of blood or body temperature. Sometimes these nerves pass pain information to your central nervous system resulting in spinal or leg pain (sciatica).

What happens during lumbar sympathetic blocks?

Lumbar sympathetic blocks take 10 – 30 minutes. They are done using local anaesthetic with light sedation.

You will lie on your side or stomach. An assistant may spray an antiseptic solution on your back which is very cold. Using a very fine needle they will insert local anaesthetic into the area to numb it before the block needle is inserted. Using an x-ray they will guide the block needle(s) into position. A test dose of dye will be inserted to confirm the medication will flow into the painful area(s). If the test area is correct an anaesthetic will be slowly inserted. Sometimes a steroid is also injected to enhance the effect of the anaesthetic. Your consultant will use the x-ray to confirm the flow of medication and that the area is covered. The block needle is withdrawn and a plaster may be applied to the injection site(s).

After lumbar sympathetic blocks

Immediately after your injection(s) you may feel your lower body getting warm. Your pain may be gone or have decreased. Sometimes patients experience numbness or weakness in their legs.

You will be able to go home the day of your procedure however you will not be able to drive. Please arrange for someone to take you home.

You should rest and avoid strenuous activity for a day or two following your block. You may be able to return to work the day after your procedure. Please discuss this with your consultant.

The local anaesthetic should wear off within hours. The site of your injection(s) may be sore. This should ease quickly.

The actual block may last for many hours. Patients who respond to blocks may be candidates for repeat blocks. Usually a series of blocks is needed to treat the problem. In most cases the duration of relief increases with each injection.

It is not possible to predict how you will respond to lumbar sympathetic blocks. Be sure to discuss any concerns you have with your consultant.

Complications from lumbar sympathetic blocks are rare but could include:

  • Bleeding
  • Infection
  • Increase pain
  • Spinal block
  • Injection into wrong area

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