LUMBAR SYMPATHETIC BLOCK

Indications

This procedure is indicated for use with pain conditions caused by complex regional pain syndromes of the lower extremity, peripheral neuropathy, RSD of the lower extremity, pelvic type pain, shingles in the mid-thoracic, lumbar and lower extremity region, and some sympathetic nerve-mediated pain syndromes of the thoracic and lumbar areas area. For sympathetic pain from the pelvic area, the lower ganglion may need to be blocked in the L5 and sacral regions or even in the coccyx area.

What to expect

The patient will be face down under fluoroscopy (x-ray) with a cushion under their abdomen to arch the back in a ‘mad cat’ type of position. The cushion is needed so that it brings the lower lumbar ganglion area closer to the surface. The operator will feel and identify the muscles of the lumbar spine after injection local of anesthesia in the skin to numb the area first. A needle will be placed through the numb skin and down to the lumbar ganglion on the anterior surface of the bone with the guidance of an x-ray. Contrast can be used to identify proper placement and then injection of local long-lasting anesthetic and steroid medications can be done in small intermittent doses while keeping contact with the patient.