Lumbar Sympathetic Blocks

Is a Lumbar Sympathetic Block Right for You?

This treatment is most often recommended for those who have sympathetically mediated pain, meaning the sympathetic nerves are helping to keep the pain going. Examples include Complex Regional Pain Syndrome (CRPS) affecting the leg or foot, phantom limb pain or cancer-related pain.

You may be a good candidate if:

• Pain, color, or temperature changes stay mainly in one leg or foot.
• Conservative treatments such as medications, physical therapy, or other injections have not provided lasting relief.
• You and your doctor wish to limit long‑term opioid use or avoid more invasive surgery.

HOW DO LUMBAR SYMPATHETIC BLOCKS WORK TO CONTROL MY PAIN?

Think of the sympathetic nerves as a dimmer switch that can get stuck on high. With the help of live X-ray imaging, your doctor carefully guides a thin needle through your back to reach the front side of the L2, L3, or L4 vertebrae. A small amount of contrast dye confirms exact placement. Local anesthetic is then injected to temporarily “turn down” the nerve activity. If you feel relief, additional blocks or longer‑acting treatments may be considered.

What to Expect During the Procedure

During your initial visit, your pain management doctor will review your symptoms, medical history, and any imaging studies. Be sure to discuss daily medications, especially blood thinners, during this review. If light sedation will be used, you will be asked to stop eating and drinking several hours before the procedure and arrange a ride home.

On the day of your procedure, you will lie face down on an X‑ray table. After the skin is numbed, the doctor will guide the needle to the sympathetic chain, confirm the location with contrast dye, and deliver the medication. The entire procedure usually takes less than 30 minutes. You will rest for about an hour so our team can check your leg temperature and blood pressure to make sure the block is working and that you’re feeling okay.

What to Expect After the Injection

If sedation was used, plan to rest for the remainder of the day and avoid driving. Mild back soreness is common and generally fades within 24 hours. Many individuals experience a warm sensation and pain relief right away; for others, relief builds over several days. Benefits often last weeks to months, and a short series of blocks (typically two or three, spaced a few weeks apart) may extend the relief. Light walking is usually safe the next day unless your pain management physician advises otherwise.

Follow‑Up Care

Expect a follow‑up call or visit within one to two weeks to discuss your results and decide whether another block or a different therapy is appropriate. Your care team may also recommend physical therapy or gentle exercises to strengthen the affected limb and support long‑term improvement.

Common Questions About Lumbar Sympathetic Blocks

Does the injection hurt? 

You will feel a quick pinch when the skin is numbed. After that, most people report only mild pressure.

How long will the pain relief last?

Relief varies, but many people feel better for several weeks or months. If the first block helps, future blocks can be scheduled.

Will my leg feel strange afterward?

A warm feeling or brief numbness is normal and shows that the nerves have been affected. These sensations fade within a few hours.

How many blocks will I need?

Some people do well with one injection; others benefit from a short series.

Can I reduce my medications?

Many individuals lower their pain medications after a successful block, but always talk to your doctor before making changes.