Lumbar Sympathetic Block

Treatment Information

What is a lumbar sympathetic block?

A lumbar sympathetic block is an injection that involves the placement of local anesthetic and steroid around a group of nerves in your low back area using a needle under x-ray guidance.

 

Why would a lumbar sympathetic block be performed?

This injection may be performed if you are experiencing pain, numbness, tingling, and/or sensitivity in your lower extremities as a result of Chronic Regional Pain Syndrome (RSD), peripheral vascular disease, neuropathy, or injury.

 

Why would a lumbar sympathetic block NOT be performed?

This procedure will NOT be performed if you have a fever, active infection, bleeding problems, uncontrolled high blood pressure, allergy to the local anesthetics and steroid, and/or pregnancy.

 

What are the preparations for the procedure?

Before the procedure, you are asked NOT to eat for four (4) hours prior and NOT to drink liquids two (2) hours prior to your procedure time. You must have someone of age to drive you home following your procedure, as you will not be permitted to drive a vehicle on the day of your procedure. Anyone who is taking a blood thinning medication such as coumadin will be required to stop that medication for a specified time period before the procedure. Otherwise, you may take your regularly prescribed medications the morning of your procedure with a sip of water. If you are a diabetic patient, you may eat a limited amount before your procedure to avoid hypoglycemia.

 

What will occur during the lumbar sympathetic block?

After the procedure and complications have been explained by the physician or physician assistant, an informed consent paper, (giving permission for the procedure), must be signed by the patient. Then, the patient is taken to the procedure room by a staff member. You will then lie down on the x-ray table on your stomach. The area to be injected will be cleaned using an antiseptic solution, which is usually betadine unless you are allergic to this. Numbing medicine will then be injected under the skin to numb the area where the injection will occur. The physician will then guide a needle under x-ray to the area of nerves in your low back. Once needle placement has been confirmed on x-ray, a small amount of local anesthetic and steroid will be injected.

 

How long is the procedure?

The lumbar sympathetic block lasts between 15-20 minutes.

 

What are possible complications from the procedure?

This procedure does come with risks. Complications that can occur include but are not limited to infection, discitis, trauma to the spinal cord or exiting nerve roots, trauma to the intervertebral disc, damage to abdominal organs, reaction to the steroid medication, and epidural, subdural, and subarachnoid injections.

 

What are possible side effects of steroid medication?

Administration of steroid medication can cause side effects. Side effects can include but not limited to hyperglycemia, altered menstrual cycle, fluid retention, bruising, insomnia, sweats, hot/cold flashes, flushing of the face, weight gain, epidural lipomatosis, steroid myopathy, avascular necrosis of bone, osteoporosis, and Cushing’s syndrome.

 

What happens after the procedure?

After the procedure is completed, the patient is taken to our recovery area. There, you will be monitored closely by checking the blood pressure, heart rate, and pain score level. You may be given something to drink at this time. Also, the staff will be observing for any signs of side effects from the procedure. When ready, you will be given discharge instructions and any follow-up information that is needed. Remember, you may experience numbness in the affected area until the local anesthetic wears off completely. In addition, it can take up to 72 hours before you feel the full effects of the sympathetic block.

 

Important Notes

  • If you suspect you might be pregnant or know you are pregnant, please notify the physician or any staff member, as this is a reason NOT to do the lumbar sympathetic block.
  • If you are a diabetic patient taking insulin or pills to manage your diabetes, the steroid used in the lumbar sympathetic block can raise your blood sugar level temporarily. You should monitor your blood sugar level closely after your procedure. If your blood sugar level continues to be elevated then contact your primary care physician for suggestions on how to best manage this issue.
  • After the procedure, you should resume your regular medications as you are prescribed if those medications were stopped before the injection.
  • On the day of the procedure, you should not plan any strenuous activities. Usually, patients are able to resume their regular daily activities on the following day.

* If you do not understand any part of the above material, please discuss it with your physician or physician assistant. *

 

Related Information

Other Treatments

 

Related Documents

Discharge Instructions

Patient Pain Diary

 

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