What is a Lumbar Sympathetic Plexus Block?
The sympathetic plexus is a bundle of nerves located on either side of the spine. These nerves are part of the sympathetic nervous system. Normally these nerves control basic functions like maintenance and regulation of blood flow to the extremities. In some circumstances, these sympathetic nerves can carry pain signals from tissue to the spinal cord. A lumbar sympathetic block is an injection of local anesthetic into or around these sympathetic nerves.
Am I a candidate for a Lumbar Sympathetic Plexus Block?
Typical condition(s) treated with a Lumbar Sympathetic Block, include leg or foot pain caused by trauma or surgery that has resulted in a persistent condition of severe pain. This condition is termed Reflex Sympathetic Dystrophy or Causalgia. Blocking the sympathetic plexus may reduce the pain, swelling, and unusual changes in the limb and may improve mobility.
How long does the procedure take?
The actual injection typical takes about 10 minutes.
What is injected?
Typically anesthetic and a steroid are injected.
Where is the procedure performed?
It is typically done in an office or surgical suite using fluoroscopy.
How is the procedure performed?
Typically an IV is started so that the anesthesiologist can administer sedating medication to make you comfortable. Your doctor will typically identify the area he will be injecting using the X-ray machine, and then provide some local numbing medication (Lidocaine) before placement of the needle. The needle is advanced using x-ray guidance along the vertebral body. Needle position is confirmed with the injection of contrast dye, special technique, and the X-ray images. The dye will not be used if there is an allergy. Once needle placement is assured, the therapeutic solution is injected.
What if I am afraid of needles?
Typically patients with needle phobia do just fine with sedation to help relax them. They also typically will have little to no memory of the actual procedure.
Is it painful?
Generally no, your doctor will do everything possible to minimize and discomfort during the procedure. This may require sedation and is typically achieved with the numbing medication (lidocaine).
What are the risks and side effects?
The procedure is generally safe. However, with any procedure or medications there are potential risk, complications, and side effects. The most common side effects include temporary pain or soreness at the injection site. Uncommon risks include bleeding, infection, spinal block, epidural block, and injection into the blood vessels and surrounding organs.
How many Lumbar Sympathetic Plexus Blocks do I need to have?
If you respond to the initial injection, it may be beneficial to have repeated injections. Usually a series of injections is required to treat the problem and reverse the pain process. Patient response is highly variable.
How long does the effect of the medication last?
The response is variable. Typically the degree and duration of response increases with each additional injection.
What can I expect following the injection?
Some people report soreness at the injection site. Some patients will report red tinged urine; this is typically normal. Generally most people return to work the following day.