Overview
A lumbar sympathetic block is an injection of numbing medicine near the sympathetic nerve chain in the low back. These nerves can contribute to certain types of chronic pain in the legs.
GSMC is led by Dr. Dharam Mann, who completed fellowships in pain management, cardiac anesthesia and critical care at Massachusetts General Hospital/Harvard.
It is mainly used to diagnose and treat complex regional pain syndrome (CRPS) of the leg and other sympathetically maintained pain.
How it works
Using X-ray guidance, the physician places a needle beside the spine at the target level and injects a local anesthetic near the sympathetic chain.
Who it may be for
- Complex regional pain syndrome of the leg
- Certain nerve pain conditions of the lower limbs
- Some circulation-related pain
Your exam and imaging decide whether this treatment is appropriate for you.
What to expect
- Before: we review your medications (especially blood thinners), allergies and imaging. You may need a driver.
- During: you lie on a procedure table, the skin is cleaned and numbed, and the physician uses X-ray (fluoroscopy) or ultrasound guidance to place the needle.
- After: you are monitored briefly and usually go home the same day. Keep a pain diary so we can judge the response.
Recovery
Your leg may feel warm for several hours, which is expected. Arrange a driver. Your instructions may differ.
Risks and side effects
Every procedure has risks. Your physician will review them with you, including:
- Temporary soreness at the injection site
- Temporary increase in pain
- Bleeding or bruising
- Infection (uncommon)
- Allergic reaction (rare)
- Temporary rise in blood sugar if a steroid is used
- Temporary leg numbness or weakness
Insurance and cost
Many plans, including Medicare, may cover this treatment when criteria are met. We verify benefits before scheduling. See accepted insurance.
Frequently asked questions
Why does my leg feel warm afterward?
Blocking the sympathetic nerves increases blood flow, which is a sign the block reached its target.
Is a series needed?
Some patients benefit from a series. Your physician will decide based on your response.
Is CRPS the only reason for this block?
It is the most common reason, but there are other uses for selected patients.
What are the common side effects of a nerve block?
Most side effects are mild and short-lived: soreness at the injection site, warmth or redness in the treated limb, temporary numbness or weakness, and a hoarse voice or droopy eyelid after blocks in the neck. If a steroid is used, some people notice flushing, trouble sleeping or higher blood sugar for a few days. Call us for fever, worsening pain, or weakness or numbness that does not go away.
How long does a nerve block last?
The numbing medicine wears off within hours, but pain relief can last longer. Some people get days of relief, others weeks or more, and some need a series. How long it lasts helps guide your next step.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.