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Lumbar Sympathetic Nerve Block

What is a Lumbar Sympathetic Nerve Block?

The sympathetic nerves are a group of nerves found along the front side of the spinal column. They are part of the autonomic nervous system and control many bodily functions including sweating, heart rate, digestion, and blood pressure. Sometimes these nerves can continue to transmit pain following an injury even after the injury has healed. This can result in a condition known as Chronic Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD). Symptoms of CRPS include severe burning pain, swelling, and skin color changes.

A lumbar sympathetic nerve block is a special test to help your doctor find the cause of your symptoms. During the test, an anesthetic (numbing) medication is injected near your spine. This “blocks” the sympathetic nerves in that region. If these nerves are causing your symptoms, the injection may offer relief for a while immediately after the procedure. If effective, your pain management doctor may recommend a series of these blocks 1-2 weeks apart which may help give you more long term pain relief.

How Do I Prepare For My Procedure?

No solid food or fluids after midnight prior to the procedure unless directed otherwise. You may take your medications with a small amount of water. Diabetics should not take their medication for diabetes until after the procedure is complete. Please check your blood sugar at home before arriving at the PMC. If you are taking any blood thinners such as Coumadin, Warfarin, Plavix, or any others, these medications must be discontinued well before the procedure. You will be directed by our staff as to when you should stop this medication. Please make your doctor aware that you are taking a blood thinner, and contact your primary care physician or prescribing physician before stopping this medication.

What are the Risks?

Complications are rare, but can include infection, bleeding, spinal or epidural block and injection into a blood vessel.

Conditions and Symptoms a Lumbar Sympathetic Nerve Blocks Treats

Before being referred for a sympathetic nerve block, you must undergo a preliminary consultation with our physicians. In this appointment, they’ll use a collaborative approach to discuss your concerns and examine your medical history and symptoms. If needed, they’ll refer you for advanced diagnostic imaging before deciding on the right treatment.

It’s not always guaranteed, but if you have the following conditions or symptoms, there’s a chance of eligibility for a nerve block:

In addition to treating pain, they might use this procedure to diagnose your source of pain or as a form of pain relief for spinal surgeries.

How is a Lumbar Sympathetic Nerve Block Performed?

Lumbar sympathetic nerve blocks are usually done on an outpatient basis. After an initial consultation, you’ll likely be advised to stop taking certain medications like blood thinners, to fast beforehand, to stop smoking, and to cut back on alcohol.

Then, on the day of the procedure, your doctor will:

  1. Place you on your stomach or side
  2. Clean the skin and use a local anesthetic to numb the skin and tissues for the injection
  3. They’ll then carefully insert a thin needle into the epidural space of your lower back
  4. Once the needle is positioned, they’ll inject the medication

After the procedure, you’ll be kept in for 30-60 minutes for close observation to make sure you don’t react to the medication. You’ll be informed not to drive home due to the numbness from the anesthetic and will be able to return to regular activities the following day.


What Are the Risks of a Lumbar Sympathetic Nerve Block?

At Pro Spine & Pain, complications from this procedure are rare. If they are to arise, they are infection from medication, injury to the spinal cord or nerve roots, bleeding, or a retroperitoneal hematoma. We conduct extensive consultations and diagnostic imaging to ensure these risks are minimized.

What to Expect After a Sympathetic Nerve Block?

After the treatment, you can go home on the same day and return to regular activities the following day. Due to temporary numbness from the anesthetic, you’ll need someone to drive you home. Sometimes, temporary soreness, warmth, and weakness can arise once the medication subsides.

Can You Walk After a Lumbar Sympathetic Nerve Block?

After the procedure, you’ll likely be able to walk and resume your routine the following day.

Updated on Apr 15, 2024 by Dr. Thomas Stauss (Pain Management) of Pro Spine & Pain

Thomas Stauss, MD

Thomas Stauss, MD, completed both his undergraduate and medical studies at the esteemed University of Wisconsin in Madison. Dr. Stauss values having access to a wide array of cutting-edge treatment options, ensuring effective relief for his patients' discomfort and a significant enhancement in their quality of life. More specifically, he specializes in utilizing implanted devices to manage chronic pain. Dr. Stauss’s primary objective is to uphold the dignity of each patient while delivering ethical and professional services.

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