A lumbar sympathetic block is a minimally invasive injection therapy that helps diagnose and treat pain affecting the sympathetic nervous system. The lumbar sympathetic chain and ganglia transmit signals from the spine to the thighs, legs, and feet. Patients with foot and leg pain, reflex sympathetic dystrophy, peripheral vascular disease, and other conditions that affect the sympathetic nervous system are usually considered to be ideal candidates for this procedure. As alluded to previously, these injections may be used as a diagnostic tool or as a therapeutic treatment. However, if more than three injections are needed, it is prudent to consider alternative treatment options such as spinal cord stimulation to minimize the possibility of tissue and bone damage.
A lumbar sympathetic block can take anywhere from ten to thirty minutes to complete. To begin the procedure, a physician thoroughly cleanses the skin surrounding the injection site to reduce the risk of infection. At Orthopedic and Wellness, a lumbar sympathetic block is always performed under x-ray fluoroscopic guidance usually with minimal or no sedation. Additionally, physicians use fluoroscopy in conjunction with an iodinated contrast dye to outline the sympathetic chain. Once the skin has been anesthetized, a long, thin needle is inserted several inches into the spine, angling toward the side and front of the spine. After the appropriate location is reached, iodinated contrast dye and local anesthetics are injected to interrupt the transmission of pain signals. Onset of pain relief is nearly immediate if the sympathetic nervous system is carrying the painful signals through this ganglion. The needle is removed and a bandage is placed over the injection site after the anesthetic has been administered. Patients are then taken to a separate room to recover.
Patients will be tasked with monitoring their pain levels and symptoms six hours after the procedure. If a patient experiences significant pain relief from the first injection, a lumbar sympathetic block may be repeated two or three times within a year to continue these effects. A series of these blocks is reasonable to desensitize the nervous system, but if more than three blocks are used in a three-month time period, other treatment options may need to be considered. If a patient experiences new, onset, severe low back pain; new abdominal pain; shortness of breath; numbness in the legs; or a fever over 101.5 degrees after the injection, they should contact their Orthopedic and Wellness physician immediately. Ice may be placed over the injection site for 10 minutes at a time, several times a day to help decrease pain and inflammation.