Lumbar Sympathetic Block

Different types of spinal injections carry different risks. Your doctor will explain the specific risks of your procedure. These potential risks are common to many spinal injections:

• Nerve problems that cause arm or leg weakness
• Increasing feelings of numbness
• Briefly increased pain or severe increased pain
• Incontinence
• A type of post-injection headache (“spinal headache”)
• Bleeding, infection (rare)
• Stroke
• Spinal cord injury

Potential benefits of employing a lumbar sympathetic block include:

• May relieve or diagnose pain
• Is less invasive than surgery, fewer risks
• Allows fast recovery
• Does not require a hospital stay

The actual lumbar sympathetic block injection takes only a few minutes, but plan on 30 to 60 minutes for the whole procedure. You will remain awake and able to communicate the entire time. Your procedure will include:

• Monitoring. You may have devices attached to you to check your heart rate and breathing.
• Sedative. You may be given a sedative to help you relax.
• Position. You may lie face down, face up, or on your side.
• Local anesthetic. You’ll be given a local anesthetic near the injection site to numb the skin. This usually feels like a pinprick with some burning and only lasts a second.
• Fluoroscopic x-ray guidance. The doctor may inject a contrast dye that helps identify specific parts of your spine and confirm correct needle placement.
• Injection. Numbing medicines or anti-inflammatory medicines (steroids) will be injected into your spine.

After the lumbar sympathetic block procedure, you may stay in a recovery area and have your vital signs (heart rate, blood pressure, breathing rate) monitored. You should be able to walk immediately after the procedure, although some patients experience leg weakness, numbness, or tingling for a few hours. You may be asked to fill out some paperwork before leaving.

These are things to be aware of as you’re recovering at home:

• Driving. Someone may need to drive you home after the procedure. Your doctor will likely allow you to resume driving the next day.
• Possible side effects. You may experience briefly increased pain, headaches, or trouble sleeping. These should go away in the first few days.
• Food and drink. You may be asked not to eat or drink for a few hours.
• Activity. You may be asked to take it easy on the day of the injection. But it may help to get up and move around every hour or so. You should be able to resume normal activity the next day. Walk around if you feel up to it, but avoid activities that may strain your back.
• Showering and bathing. You can take a shower, but avoid baths or pools for 48 hours.
• Returning to work. Ask your doctor when you can return to work.
• Follow up. Be SURE to follow up with your doctor in two weeks or as otherwise instructed.

A lumbar sympathetic block provides anesthetic relief to nerves surrounding the spine, the lower back, and the lower part of the body including the legs. Your provider might recommend a lumbar sympathetic block for a few different reasons:

1. Pain diagnosis. Your doctor may inject an anesthetic like a lumbar sympathetic block to block feeling in a particular part of the lower body. If the pain is relieved, your physician will have a better understanding of your individual pain situation.
2. Pain relief. Your provider could also use a lumbar sympathetic block to reduce pain, decrease swelling, and improve mobility or flexibility.

These are things you can do to make your lumbar sympathetic block injection go better:

• Bring any x-ray films, MRIs, or CT scans with you to your appointment.
• Bring a list of all your current medicines. Be sure to include everything, including over-the-counter medicines and vitamins. And tell your healthcare providers if you have allergies to any medicines. You may be asked to stop taking certain blood thinners, such as Plavix and Coumadin, before the procedure. Always check with your healthcare providers before stopping any medicines.
• If the purpose of your injection is to diagnose, do not take your pain medicine. Arrive at your appointment feeling your usual amount of pain. This will make it easier tell if the injection relieved your pain.
• Ask your healthcare providers about food and drink. You may be asked not to eat or drink anything for 4 to 8 hours before the procedure.
• Tell your healthcare providers if you are ill or pregnant. If you have a cold, flu, or other illness the day of the procedure, or if there is any chance you may be pregnant, be sure to tell your healthcare providers.
• Wear loose clothing. Wear clothing that won’t rub against the site of the injection.