Lumbar Sympathetic Nerve Block

What are the sympathetic nerves?
The sympathetic nerves run on the front surface of the spinal column (not in the spinal canal with the nerves from the central nervous system). The sympathetic nerves are part of the autonomic nervous system, which basically controls functions. However, there is a connection between the central and autonomic nervous systems. Sometimes arm or leg pain is caused by a malfunction of the autonomic system secondary to an injury.

What is a sympathetic nerve block and why is it helpful?
A sympathetic nerve block involves injecting medicine around the sympathetic nerves in the lumbar or cervical area. By doing this, the system is temporarily blocked in hopes of reducing or eliminating pain. If the initial block is successful, then additional blocks may be repeated until the pain diminishes.

What happens during the procedure?
The patient is placed on an xray table on their back for a cervical block or on their stomach for a lumbar block. The skin on the neck or the low back is cleansed using a sterile solution called Betadine. Next, the physician injects a small area of the skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle, using x-ray guidance to the area of the sympathetic nerves. A small amount of contrast (dye) is injected to insure proper needle position. Then, a combination of numbing medicine (anesthetic) and normal saline is usually injected.

What happens after the procedure?
Immediately after the procedure, the patient will be moved to the recovery area where they are monitored for a period of time. The recovery room nurse checks the patient periodically to see if they get good arm/hand or good leg/foot warming. A follow-up plan will be made. A repeat procedure may be scheduled if indicated. Patients are then asked to report the percentage of pain relief and report the relief experienced during the next week by calling the clinic. The arm(s) or leg(s) may feel weak or numb for a few hours. This is fairly common and can happen following a sympathetic nerve block, but not always.

General Pre/Post Instructions
Patients may eat a light meal before the procedure. If a patient is an insulin dependent diabetic, they should take their insulin and eat prior to the procedure.

Patients may take their routine medications. (e.g. high blood pressure and oral diabetic medications). If a patient is on Coumadin, Lovenox, or Plavix (blood thinners) they should notify the office so that dosing may be individualized, if necessary, according to the patient's diagnosis.

If you are allergic to iodine, contrast, or medical dye, please inform the office. Patients can expect to be at the facility approximately 1½-2 hours.

A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work unless otherwise instructed by the physician.