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Lumbar Sympathetic Block

What is a lumbar sympathetic block?

A lumbar sympathetic block is an injection of medication that helps relieve lower back or leg pain (sciatica). It can be used to treat:

  • Reflex sympathetic dystrophy
  • Complex regional pain syndrome
  • Herpes zoster infection (shingles) involving the legs
  • Vascular insufficiency
  • Peripheral neuropathy

Sympathetic nerves are located on both sides of your spine, in your lower back. A steroid medication and local anesthetic injected into or around your sympathetic nerves can help reduce pain in that area.

How is a lumbar sympathetic block done?

First, you’ll be given an intravenous medication to relax you. Then, you’ll lie on your stomach on an x-ray table.

The doctor will numb an area of skin on your lower back with a local anesthetic. Then, guided by an x-ray, he or she will:

  • Insert a needle into your back, along the outside of your spine
  • Inject dye to confirm that medication will go to the correct spot
  • Inject a steroid medication

Usually, the procedure takes less than 30 minutes, and you can go home the same day.

How effective is a lumbar sympathetic block?

Some patients report pain relief immediately after the injection, but the pain may return a few hours later as the anesthetic wears off. Longer term relief usually begins in two to three days, once the steroid begins to work.

Usually people need a series of injections to continue the pain relief. Sometimes it takes only two injections; sometimes it takes more than 10.

What are the risks?

The risk of complication from a lumbar sympathetic block is very low. However, there could be bruising or soreness at the injection site. Serious complications, including infection and bleeding, are uncommon.

What happens after the procedure?

Your lower back and leg may feel warm or “different,” and you may begin to feel less pain. Your leg may feel numb or weak, but this feeling will subside when the anesthetic wears off.

You can continue your regular diet and medications immediately, but do not drive or do any rigorous activity for 24 hours after the procedure. Take it easy. You can return to your normal activities the next day.

Is a lumbar sympathetic block right for you?

A lumbar sympathetic block may be right for you if you have lower back or leg pain — especially linked to reflex sympathetic dystrophy or complex regional pain syndrome — which does not respond to other treatment.

Talk to your physician about it. To schedule an evaluation at Cleveland Clinic’s Department of Pain Management call 216.444.PAIN (7246) or 800.392.3353