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Lumbar Sympathetic Block for RSD

What is a Lumbar Sympathetic Block?

Lumbar Sympathetic Block is an injection of local anesthetic in the “sympathetic nerve tissue” – the nerves which are a part of Sympathetic Nervous System. The nerves are located in the back, on either side of the spine.

What is the Purpose of It?

A block is performed to determine if there is damage to the sympathetic nerve chain and if the damage is the source of pain. Primarily, this is a diagnostic test, but it may provide relief far in excess of the duration of an anesthetic.

The injection blocks the Sympathetic Nerves. This may, in turn, reduce pain, swelling, color and sweating changes in the lower extremities and may improve mobility. It is the treatment for Reflex Sympathetic Dystrophy Syndrome (RSDS), Sympathetic Maintained Pain, Complex Regional Pain Syndrome (CRPS) and Herpes Zoster (shingles) involving the lower extremities.

How Long does the Injection take and What is Injected?

The injection only takes a few minutes and consists of a local anesthetic (similar to lidocaine or bupivacaine); Epinephrine (adrenaline) or Clonidine may be added to prolong the effects of the injection.

Will the Injection Hurt?

The procedure involves inserting a needle through skin and deeper tissues (similar to a tetanus shot); there will be some discomfort involved. However, the skin and deeper tissues can be numbed with a local anesthetic using a very thin needle before inserting the larger needle for the block. Most patients also receive intravenous sedation and analgesia, making the procedure easier to tolerate.

Will I be “put out” for this procedure?

No. This procedure is done under local anesthesia. Most patients also receive intravenous sedation and analgesia, making the procedure easier to tolerate. The amount of sedation given generally depends upon the patient’s pain tolerance.

How is the Injection Performed?

The injection is performed with the patient lying on their stomach and the skin on the back is cleansed with an antiseptic solution. Fluoroscopy (X-ray) is used to guide the needle(s) into the proper position and then the injection is performed. The patient will also be monitored with EKG, a blood pressure cuff, a blood oxygen monitoring device and temperature sensing probes placed on the feet.

What Should I Expect after the Injection?

Immediately after the injection, the patient may feel their lower extremities warming and the pain lessening or gone. Some weakness and/or numbness may also be felt, but is temporary. The patient should have someone drive them home. The patient should perform as little as possible for at least a day or two after the procedure; or as tolerated based on the individual. Some patients immediately follow the procedure with physical therapy.

How Long will the Effect of the Medication Last?

The local anesthetic wears off in a few hours. However, the blockade of sympathetic nerves may last for many more hours. Usually, the duration of relief gets longer after each injection.

How many injections do I need to have?

If you respond to the first injection, you will be recommended for repeat injections. Usually, a series of such injections is needed to treat the problem. Some may need only 2 to 4 and some may need more than 10. The response to such injections varies from patient to patient.


What are the risks and side effects?

This procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain – which is temporary. The other risks involve bleeding, infection, into blood vessels and surrounding organs. Fortunately, the serious side effects and complications are uncommon.Follow us on social media: