If you are experiencing chronic leg and foot pain and you have tried using other conservative treatments but with no good results, you may benefit from lumbar sympathetic block.
A lumbar sympathetic block is an injection that contains local anesthetic and steroids used to relieve chronic leg and foot pain.
Medication containing anesthetic and corticosteroid is injected into the sympathetic nerves along the front side of the spine to numb the pain.
The sympathetic nerves are part of the autonomic nervous system. When these nerves are injured, they can sometimes transmit pain signals from the injured area to the brain, causing you to feel pain.
A sympathetic nerve block involves injecting an anesthetic into the sympathetic ganglia (cluster of nerves). In some cases, a corticosteroid may also be injected to provide longer-lasting pain relief and reduce inflammation.
Patients with chronic leg and foot pain caused by conditions such as complex regional pain syndrome, shingles, reflex sympathetic dystrophy, vascular insufficiency, and diabetic neuropathy in the legs may benefit from this procedure.
Preparations for a lumbar sympathetic block
Before undergoing a lumbar sympathetic block, your doctor will first review your medical history. You may be asked some questions regarding the nature of your pain.
You may need to undergo imaging scans so that your doctor will pinpoint the exact spot where the pain is coming from.
If may need to stop taking blood-thinning medications for several days prior to the procedure.
Inform your doctor if you’re currently on any medication, supplements, or herbs.
You will need to make arrangements for someone that will drive you back home after the procedure because you won’t be allowed to drive.
The procedure of a Lumbar sympathetic block
You will first be administered a low-dose sedative to make you comfortable throughout the procedure. You will remain awake so that you can provide feedback to your doctor on how you’re feeling.
You will lie face down. Your doctor will clean the area where the needle will be inserted with a solution. A local anesthetic will also be used to numb the skin so that you don’t feel pain.
With the aid of fluoroscopic guidance, your doctor will insert a hollow needle through your skin and direct it to the lumbar sympathetic ganglia.
Your doctor will inject a contrast dye into the area to allow him or her to see clearly where the needle is placed.
When the needle is in the proper position, your doctor will inject the medication containing anesthetic and steroid.
The needle is removed after the medication has been delivered.
After the injection
You may feel warmth or fullness as the medication is delivered along with temporary numbness or weakness in your limb.
You will be taken to a recovery room and be monitored for 15 to 30 minutes until you recover from the numbness and weakness.
You can go back home when you recover but someone will need to drive you home.
You can go back to work or resume your normal activities the next day.
Avoid immersing yourself in water such as swimming or soaking yourself in a bathtub for the next 72 hours.
Results from lumbar sympathetic block
Many patients experience immediate pain relief from the anesthetic injected. The anesthetic works immediately and wears off after a few hours. It takes 2-3 days before the corticosteroid starts to work. You will experience longer-lasting pain relief when the corticosteroid starts to work.
Most patients may require multiple injections to achieve long-lasting pain relief.
How effective is a lumbar sympathetic block?
Lumbar sympathetic block is beneficial for patients experiencing chronic pain in their feet and legs who have not experienced any improvements from taking pills every other day. It is effective for pain relief and most patients have reported immediate pain relief after the injection. Immediate pain relief is provided by the anesthetic while longer-lasting pain relief is provided by the corticosteroid.
How often can you have lumbar sympathetic ganglion block injections?
How you can have lumbar sympathetic block varies from person to person. Your doctor may recommend a series of lumbar sympathetic block injections 1-2 weeks apart to provide more long-term pain relief.
How long does a lumbar sympathetic block last?
Some patients experience immediate pain relief after having the injection. Immediate pain relief is provided by the anesthetic. The effect of the anesthetic lasts for only a few hours. When the effect of the anesthetic wears off, patients may start to feel pain again. It takes between 2-3 days for the corticosteroids to start to work. Patients experience longer-lasting pain relief when the corticosteroids start working.
What happens when a sympathetic nerve block doesn’t work?
Sympathetic nerves spread out from your spine and they control some of the body functions you have no control over. They also carry pain signals from different parts of the body to the brain. When sympathetic nerves start malfunctioning or aren’t working right, such as after an injury, you may begin to experience chronic pain.
When the nerve block doesn’t work, it may be an indication that you’re not a right candidate for the procedure or the nerves are not responsible for the pain. In such cases, your doctor will suggest other appropriate treatment options.
How long does it take for a lumbar nerve block to work?
After the temporary pain relief provided by the anesthetic has worn off, the steroid usually starts to work in 2-3 days. You will experience longer-lasting pain relief when the steroid starts working. The lasting effects of the steroid vary from person to person.