Sympathetic Nerve Block

• Lumbar Sympathetic Block
• Spinal Nerve Blocks

Sympathetic nerves located in the lower spine control basic functions such as regulating blood flow. They also carry pain signals from tissues to the spinal cord.

A lumbar sympathetic block is an injection of a local anesthetic and steroid into or around the sympathetic nerves to block the transmission of pain impulses from the legs or lower back, thereby relieving pain.

The lumbar sympathetic block is usually indicated as a treatment for conditions such as:

• Reflex sympathetic dystrophy (pain and dysfunction of an extremity)
• Herpes zoster infection
• Vascular insufficiency (impaired blood flow)
• Peripheral neuropathy (nerve damage)

You are contraindicated for this procedure if you are allergic to the medications being injected, are taking blood-thinning medications, have an active infection, diabetes or a heart disorder.

The lumbar sympathetic block is performed under local anesthesia and sedation in an outpatient setting. You will lie flat on your stomach. Dr. Vengurlekar will numb the area of your lower back to be treated. With the help of live X-rays, Dr. Vengurlekar will insert a needle into your back. A dye is then injected to check the correct path of the medication. When this is confirmed, the steroid medication and anesthetic are injected into the target site. The entire procedure usually takes less than 30 minutes.

After the procedure, you may feel warmth in your lower back and your legs may feel numb or weak. You may have pain relief immediately after the injection, but pain may return after a few hours as the anesthesia wears off. Relief from the medication is observed in 2 to 3 days, as the steroid begins to work. Most often you will need 2 to 10 injections at regular intervals to get continued pain relief.

This procedure is usually safe and the risks are rare. However, as with most therapeutic procedures, a lumbar sympathetic block may be associated with certain side effects such as temporary pain or soreness at the site of injection, bleeding, and infection.

A spinal nerve block is an injection of an anesthetic and steroid medication around the spinal nerve root to diagnose or treat pain.

Spinal nerve blocks are indicated to relieve pain, weakness, numbness and tingling sensations in your neck, back, and extremities due to nerve injuries such as a pinched nerve or narrowing of the spinal column (stenosis).

You should not eat or drink anything after midnight the night before the procedure. You may take your medications with water. You may have to temporarily discontinue certain medications such as blood thinners or diabetic medication. The procedure is not performed if you have an ongoing infection or elevated blood pressure.

• A spinal nerve block is an outpatient procedure.
• You will lie on your stomach on an X-ray table and Dr. Vengurlekar will administer a sedative intravenously to help you relax during the procedure.
• Your vitals are constantly monitored.
• Dr. Vengurlekar locates the target site with the help of X-ray imaging.
• A contrast dye is used to ensure that the needle is accurately placed and the medication is then delivered to the target site.
• If the nerve block is performed as a diagnostic procedure, you will be instructed to note any changes in pain at different intervals. This helps Dr. Vengurlekar evaluate which nerve is causing pain.
• This helps Dr. Vengurlekar evaluate which nerve is causing pain.
• The entire procedure takes approximately 15 to 30 minutes.

You may have pain relief immediately after the injection, but pain may return after a few hours as the anesthesia wears off. The effects of the treatment will be usually noticed 2 or 3 days after the treatment. If you respond well to the first injection, you may be advised to have another injection after a period of time for better relief.

As with any procedure, a spinal nerve block may be associated with certain risks and complications such as pain (temporary), bruising, infection at the site of the injection and nerve damage.