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Lumbar Sympathetic Block

The lumbar sympathetic nerves extend from the first to the fifth lumbar (lower back) vertebrae. The lumbar sympathetic nerves run down either side of the spinal column. These nerves supply sensation of the lower extremities.

Benefits

  • Pain relief and improved healing of skin lesions.
  • Improved blood flow to lower extremities.

Preparation

  • You must not have eaten for at least 6 hours prior to your scheduled appointment.
  • You must be accompanied by a person who can drive you home. You may be given sedation, which alters your driving abilities. You may experience leg weakness after the procedure.
  • The nurse will start an IV and place a blood pressure cuff on you. Also, EKG leads will be put on your chest. The nurse will monitor your blood pressure and pulse. A temperature pad will be placed on your affected foot.
  • You may be given sedation through your IV to help you relax.
  • You will read and sign a consent form for the procedure.
  • You will be positioned on your stomach with a pillow under your abdomen. This makes the lumbar area easier to reach.
  • You will feel the doctor pressing and marking the anatomical landmarks (certain bony areas) on your lower back.
  • The area to be blocked will be cleaned and anesthetized (numbed) before the procedure starts.

Indications

  • Causalgia or other sympathetic dystrophy’s.
  • Pain due to peripheral vascular disease.
  • Phantom limb pain.
  • Acute herpes zoster.
  • Post herpetic neuralgia.

Possible Risks

Lumbar sympathetic blocks can be safely done as an outpatient at the Pain Control Center. There is a potential risk of complications. However, with this block these are rare. They include puncture of blood vessel, seizures, backache, headache, neuralgia, chronic back pain, and temporary spinal block or disc perforation. Although the complications are rare, there are experienced doctors and nurses close at hand to handle these problems should any of them arise.

Frequency of Treatment

Lumbar sympathetic blocks are usually repeated at 2 to4 week intervals. A series of 4-6 blocks is the average number done to obtain prolonged relief.

What to expect after a block

  • You will feel increased warmth due to increased blood flow to the lower extremities.
  • You may feel some numbness and tingling in the affected extremity, as well as leg weakness. These symptoms usually go away in 4-6 hours.
  • There may be some backache from needle insertion. Sleeping on a heating pad and taking one or two Tylenol tablets, or using ice on this area can usually relieve this.
  • The desired effect is a decrease in your pain. You will need to tell your doctor if the pain stops, slows down, or in any way changes (and for how long this change lasted).
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