Sympathetic Nerve Block

Lumbar Sympathetic Nerve Block

A sympathetic nerve block can be helpful in treating a painful extremity.  It is most commonly performed for lower extremity pain from Complex Regional Pain Syndrome ( please see our “conditions” section for more information on this problem).  It can change how the nerves and blood vessels in that extremity respond to injury and disease.


When a nerve is excited or injured, its endings release chemicals. These chemicals cause an opening of the blood vessels. This results in inflammation which then leads to more stimulation of the sensory nerve fibers. Over time, an increased sensitivity to pain occurs. Arms, wrists, hands, fingers, legs, ankles and feet are the regions of the body rich in nerve endings and are most commonly affected. If you experience tingling, swelling, numbness, discoloration, or pain in your extremities this treatment may be right for you.

The sympathetic nervous system can also become overactive due to numerous diseases:

  • Complex regional pain syndrome (CRPS).
  • Chronic heart failure, ischemic heart disease, and hypertension.
  • Ischemic heart disease.
  • Hypertension.
  • Kidney disease.
  • Type II diabetes.
  • Metabolic syndrome and obesity.

How does it reduce pain?

Your sympathetic nerves come together outside your spine area in thick networks of nerves called ganglions. If you have pain in the upper part of your body, you may get pain relief from blocking the stellate ganglion in your neck area. If you have pain in the lower part of your body, a ganglion near the lower spine may be targeted with a lumbar sympathetic block. This temporarily ‘turns off’ the nerves and reduces pain by attempting to reset them to normal.

After the first successful administration of the nerve block, subsequent blocks can be performed if the pain continues to keep decreasing.

What to expect with procedure?

This procedure is usually performed without sedation. If you are on any blood thinners please inform us before hand as you will need to be off of your blood thinners before we are able to perform the procedure.

However, if you would like sedation please inform us before your scheduled procedure.  Once you are ready we will take you to the procedure room and lay you comfortably on your stomach.  Next, we clean your lower back with soap to provide a sterile environment for the procedure.  Next, your skin will be numbed with numbing medication.  After numbing the area you should feel pressure as we place the needle to the correct position.  The procedure is usually performed under live x-ray.  Once the needle is in the correct position we will inject the medication.

What to expect afterwards?

Side effects after a sympathetic block may include weakness, temporary soreness, or a feeling of warmth. Some patients may experience eyelid droop if they had an injection in the neck, some temporary changes in your voice, or difficulty swallowing. Sympathetic blocks don't work for every patient. Also, the pain relief may lessen over time. For others, a sympathetic block may provide weeks, months or complete pain relief.

  • Other Treatments

  • Conservative Therapy
  • Joint Injection
  • Lumbar Epidural Injection
  • Lumbar Radiofrequency Ablation (RFA)
  • Medial Branch Block
  • MLS Laser Therapy
  • Peripheral Nerve Stimulation
  • Regenerative Therapy
  • Sacroiliac Injection (SI)
  • Spinal Cord Stimulation For Diabetic Foot Pain
  • Sympathetic Nerve Block
  • Trigger Point Injection