Lumbar Sympathetic Block
What Is a Lumbar Sympathetic Block?
A lumbar sympathetic block is an injection that targets the sympathetic nerve chain running alongside the lumbar spine. These nerves regulate blood flow and pain signaling to the lower extremities. By interrupting overactive nerve signals, the procedure can significantly reduce burning, aching, or hypersensitive pain in the legs and feet.
How It Works
•A local anesthetic (and sometimes a steroid) is injected near the sympathetic nerve chain at the lumbar level under fluoroscopic or CT guidance.
•The medication temporarily "blocks" pain signals traveling from the lower limbs to the brain.
•Repeated blocks can produce cumulative, longer-lasting relief by interrupting the pain cycle.
What to Expect During the Procedure
•Preparation: You will lie face-down; the skin over the lower back is sterilized and numbed with a local anesthetic.
•Duration: The procedure typically takes 20–30 minutes from start to finish.
•Anesthesia: Local anesthetic is used; mild sedation may be offered for comfort.
•Guidance: Real-time fluoroscopy or CT imaging ensures precise needle placement.
•Same-day recovery: Most patients rest for 30–60 minutes post-procedure and go home the same day.
Conditions Treated
•Complex Regional Pain Syndrome (CRPS / RSD)
•Peripheral vascular disease pain
•Phantom limb pain
•Hyperhidrosis (excessive sweating)
•Frostbite-related pain
•Shingles (postherpetic neuralgia) affecting the lower extremities
Who Is a Good Candidate?
Patients who experience burning, shooting, or hypersensitive pain in the lower legs or feet — particularly those diagnosed with CRPS or vascular pain — and have not found adequate relief through medications alone are strong candidates. Your Echo PMR physician will review your imaging and medical history before recommending this procedure.
Recovery & Results
Most patients notice warmth or tingling in the leg immediately after the block, which is a sign the sympathetic nerves have been reached. Meaningful pain relief may begin within a few hours to a few days. A series of blocks spaced several weeks apart is often recommended for sustained benefit, with some patients experiencing relief lasting months.
Frequently Asked Questions
How many blocks will I need?
Most patients receive a series of 3–6 blocks, spaced 1–2 weeks apart, to achieve optimal and lasting relief.
Is the procedure painful?
The injection site is numbed with local anesthetic beforehand, so most patients report only mild pressure. Sedation is available if needed.
How long does relief last?
Relief duration varies by condition and individual response. Some patients experience weeks of improvement; others maintain relief for several months after a full series.