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Lumbar Sympathetic Block

PAIN TREATMENT

Lumbar Sympathetic Block: Pain Management

Lumbar sympathetic nerve blocks are a minimally invasive, non-surgical treatment that disrupts pain signals to the brain, offering both diagnostic and therapeutic relief for chronic pain.[1] Pain relief may last temporarily or provide long-term benefits, helping to restore one’s quality of life and reduce reliance on medication.[1] Lumbar sympathetic blocks (LSBs) are particularly effective for managing persistent pain conditions like complex regional pain syndrome (CRPS), lower back pain, leg or pelvic pain, and nerve-related pain disorders.[2]
Let’s examine how lumbar sympathetic blocks work, the conditions they treat, their benefits, and why seeking care at a reputable pain management clinic ensures effective, comprehensive treatment.

Lumbar Sympathetic Block Purpose

A lumbar sympathetic block (LSB) targets the sympathetic nerves that control various autonomic functions like blood pressure, heart rate, digestion and sweating. [3] This nerve system is responsible for your body’s “fight or flight response.[4] When these nerves become overly sensitive or irritated, it can lead to chronic pain in your lower back, pelvis, or legs. This type of nerve block aims to “reset” the nerves, stopping them from sending pain signals to your brain.

According to the Cleveland Clinic, lumbar sympathetic nerve blocks serve three purposes:

Temporary pain relief: Treats acute (sudden and short) or chronic (long-term) pain and reduces inflammation.

Diagnostics: Used to identify the exact source of pain in the lower back or lower extremities.

Postsurgical pain relief: Injections before the procedures help manage pain afterward.

How Lumbar Sympathetic Block Injections Work

If your nerves are stuck in overdrive and causing unnecessary pain, a lumbar sympathetic block is like hitting the “off” switch to give your body some much-needed relief. The injection is usually a steroid plus an anesthetic or botulinum toxin (BOTOX®) delivered to the nerve bundle in your spine that supplies the sympathetic chain to the lower half of your body.[4] The lumbar sympathetic ganglion is the bundle of nerves between L1 and L4 at the front of the lower spine.[4] This area is where the medication is delivered to block the pain nerve signals sent from the lower extremities to the brain.

The LSB injection is an outpatient procedure performed while lying on your stomach on the table.[4] You’ll receive a local anesthetic or sedation, and your provider will use imaging guidance to precisely deliver the injection to the target nerves in your back.[5] The procedure is about 30 minutes, and you’ll be restricted from heavy activity for the day, returning to regular activity the next day.

Pain management specialists use CESI to treat acute and chronic pain conditions, including:

  • Lower back pain [3]
  • Sciatica [4]
  • Herniated discs [4]
  • Degenerative disc disease [4]
  • Spinal stenosis [4]
  • Radiculopathy (nerve pain) [4]
  • Failed back syndrome or post-laminectomy syndrome [4]
  • Post-surgery back pain [5]
  • Sacroiliac joint pain[6]

Conditions Treated with Lumbar Blocks

Lumbar sympathetic nerve block injections offer a nonsurgical solution to increase blood flow and treat various conditions that cause lower back and extremities pain, including:

  • Cancer pain [4]
  • Complex regional pain syndrome (CRPS) [4]
  • Lower limb painful ischemia [4]
  • Phantom limb pain [4]
  • Neuropathic pain (nerve pain) [4]
  • Postherpetic neuralgia (Shingles pain) [4]
  • Hyperhidrosis (excessive sweating) [4]
  • Raynaud’s disease [4]
  • Vascular pain [5]
  • Chronic stomach pain [6]
  • Acute (sudden, short-term) pain [7]
  • Chronic (persistent, long-term) pain [7] 
  • Posttraumatic stress disorder (PTSD) [7]

Benefits of LSB Injections

Lumbar nerve blocks offer several significant benefits for pain management, such as targeted pain control without the use of oral systemic medications and may reduce the need for OTC or prescription drugs, including addictive opioids.[8] These injections offer a non-surgical option to control pain and reduce inflammation, allowing time for the body to recover from illness, injury or surgery.[7] Some patients report immediate, lasting pain relief that offers pain control for weeks or months.[9] By effectively managing pain, LSBs enhance a patient’s ability to perform daily activities, improving overall mobility and quality of life.
Sympathetic nerve blocks are valuable pain management treatments and diagnostic tools, helping to identify the pain sources without invasive procedures.[10] They are also considered a safe, low-risk procedure with minimal side effects.[7] LSBs are a minimally invasive, nonsurgical outpatient therapy with minimal recovery time.

Lumbar Sympathetic Block Specialists & Pain Management Clinics

Living with chronic pain can be overwhelming and exhausting, often limiting your ability to perform daily tasks. If you’re ready to take control of your pain, lumbar sympathetic nerve blocks (LSB) may be the solution for various pain-related conditions. By seeking relief from a pain management clinic, you’ll benefit from care provided by professionals trained to diagnose and treat complex pain conditions. These clinics also offer a comprehensive approach to pain management that can include physical therapy, psychological support, and other non-invasive treatments.
You don’t have to live with debilitating pain. LSB therapy is a powerful, minimally invasive tool designed to provide relief without surgery or excessive medications. Consulting a pain specialist ensures you receive expert care, with access to a broad range of treatment options that can address chronic low back, leg, and foot pain. Take the first step toward reclaiming your life—because living pain-free is possible.

Resources:

  1. Nerve Blocks. Cleveland Clinic [Internet]. Published 2019. Accessed September 08, 2024. Available from: https://my.clevelandclinic.org/health/treatments/12090-nerve-blocks 
  2. Nerve Blocks.Johns Hopkins Medicine [Internet] Accessed September 08, 2024. Available from:  https://www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks 
  3. Sympathetic Nervous System (SNS). Cleveland Clinic. Published June 6, 2022. Accessed September 08, 2024. Available from: https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-flight 
  4. Alexander CE, De Jesus O, Varacallo M. Lumbar Sympathetic Block. PubMed [Internet]. Published 2023. Accessed September 08, 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431107/ 
  5. Lumbar Sympathetic Block. Cleveland Clinic [Internet]. Accessed September 08, 2024. Available from: https://my.clevelandclinic.org/health/treatments/17187-lumbar-sympathetic-block 
  6. Sympathetic Nerve Blocks for Pain. Johns Hopkins Medicine [Internet]. Published November 19, 2019. September 08, 2024. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/sympathetic-nerve-blocks-for-pain 
  7. Doroshenko M, Turkot O, Horn DB. Sympathetic Nerve Block. PubMed [Internet]. Published 2022. Updated February 12, 2024. Accessed September 08, 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557637/ 
  8. Kandola A. Nerve block: How it works, types, and risks.Medical News Today [Intenet]. Published February 25, 2020. Accessed September 08, 2024. Available from: https://www.medicalnewstoday.com/articles/nerve-block 
  9. Lumbar Sympathetic Nerve Block. Cedars Sinai [Internet]. Accessed September 08, 2024. Available from: https://www.cedars-sinai.org/health-library/tests-and-procedures/l/lumbar-sympathetic-nerve-block.html
  10. WebMD Editorial Contributors/ Learn More About Nerve Blocks. WebMD [Internet]. Accessed September 08, 2024. Available from: https://www.webmd.com/pain-management/nerve-blocks
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