Lumbar Sympathetic Nerve Block

A Lumbar Sympathetic Nerve Block is an injection of medication near the sympathetic nerves in the lower back (lumbar spine). These nerves help regulate pain, blood flow, and sweating in the lower extremities. The procedure is often used to diagnose or treat chronic nerve-related pain.

This block is typically recommended for:

• Complex Regional Pain Syndrome (CRPS)
• Peripheral neuropathy
• Vascular insufficiency (e.g., poor circulation)
• Shingles-related pain (postherpetic neuralgia)
• Phantom limb pain

It can be used to confirm if the sympathetic nervous system is contributing to your pain and may also provide temporary or long-term relief.

Local anesthetic (sometimes combined with steroid) is injected next to the lumbar sympathetic ganglia, which lie along the front of the spine.

By temporarily blocking these nerves, the procedure can reduce pain, improve blood flow, and decrease sympathetic nerve activity.

• Medication review: Tell your provider about all medications and allergies.
• Blood thinners may need to be stopped temporarily.
• Fasting: Avoid food or drink for 6–8 hours if sedation is planned.
• Arrange for transportation home, especially if sedation is used.

• You will lie on your stomach.
• The lower back is cleaned and numbed with local anesthetic.
• A needle is guided near the sympathetic nerves using fluoroscopy (X-ray).
• A contrast dye may be used to ensure proper placement.
• Medication is injected slowly.
• Sedation: Mild sedation may be used, but is not always necessary.

What to Expect:

• You may experience warmth, redness, or a tingling sensation in the leg on the side of the injection — this is a normal and expected response.
• Pain relief may be immediate or may take a few hours to develop.
• Some patients need a series of injections for lasting relief.

Activity:

• Avoid strenuous activity for the rest of the day.
• You can usually return to normal activities the next day.
• Keep track of how your symptoms change in the hours and days following the procedure.

• If the block is helpful, it may be repeated as part of a series (e.g., weekly for a few sessions).
• Your provider may recommend transitioning to other treatments such as sympathetic nerve ablation for longer-term relief.

• Minimally invasive, outpatient procedure
• Can help diagnose and treat sympathetic nerve involvement
• May reduce pain, improve blood flow, and help regain function
• Low risk and generally well tolerated