Do you sometimes feel achy and sore legs, no matter how much medication you take or treatment you receive? Or do you have a condition like diabetes that makes it difficult to bear the pain and inflammation in your legs? Your doctor may have told you about a 'Lumbar Sympathetic Block'. While the name may sound a bit scary and complicated, it is actually a relatively simple and safe medical procedure that has brought relief to many people. Let's talk about it all in a very simple way today.
What exactly is Lumbar Sympathetic Block?
Simply put, this is a special injection that is given into your lower back. It temporarily blocks pain signals from going to your legs and feet. Sometimes, medications are added to the injection to help the damaged nerves heal.
Think of the nerves in our bodies as a network of electrical cables running throughout our bodies. These cables carry signals back and forth between the brain and the rest of the body. These signals are what allow us to feel pain, touch, and muscle activity.
A special part of this nervous system is called the `sympathetic` nerves. These control things that happen in our body without us realizing it, for example, breathing, sweating, and blood pressure. But sometimes, after some kind of accident, these `sympathetic` nerves start sending pain signals incorrectly.
The `Lumbar sympathetic` nerves are located in the lower part of our spine, just in front of the vertebrae. So this `Lumbar Sympathetic Block` injection targets those nerves. It can stop them from sending unnecessary pain signals.
What kind of things is this block used for?
This vaccine is used for three main purposes.
| Purpose | A simple description |
|---|---|
| Relieve pain | Provide temporary relief from acute or chronic pain. This injection can reduce swelling in nerves and help them heal. |
| Find the cause of the pain. | If you have pain, but your doctor can't figure out the exact cause, this injection is used as a test. If the pain decreases after the injection, it means the problem is with those nerves. If the pain doesn't decrease, the cause may be somewhere else. |
| Pain control before surgery | This injection is given before and after some surgeries to control pain. |
Conditions for which this treatment is recommended
If you have any of the following conditions affecting your legs or soles, your doctor may recommend this treatment.
- Complex Regional Pain Syndrome (CRPS): A condition of chronic, more severe pain that occurs after an accident.
- Phantom Limb Pain: The continued feeling of pain in a surgically amputated leg or arm.
- Hyperhidrosis: Excessive sweating of the hands and feet.
- Diabetes-related Neuropathy: Inflammation, numbness, and pain caused by damage to the nerves in the legs due to diabetes.
- Postherpetic Neuralgia: Nerve pain that occurs after a herpes (the same virus that causes chickenpox) infection.
- Raynaud's Disease: A condition in which blood flow to the fingers decreases, causing discoloration and pain when exposed to cold.
- Cancer pain.
- Vascular pain.
Do I need to prepare for this injection beforehand?
Most of the time, this does not require any special preparation.
However, in some cases, the doctor may decide to put you in a state of drowsiness (sedation). If so, you will be asked to fast for about 6-8 hours . Also, it is essential that someone takes you home after the procedure.
The most important thing is to follow your doctor's instructions exactly. If you have any questions, don't hesitate to ask.
How does the procedure happen?
This is usually done on an outpatient basis, without having to stay in the hospital. These are the steps that usually occur:
- You will be made to lie on your stomach on a special table.
- You may be given a sedative to help you relax, through an IV line in your arm.
- The doctor will thoroughly clean the injection site with an antiseptic solution.
- Then, another small injection is given to numb the area. At this point, you may feel a slight stinging sensation when the needle hits.
- Next, while looking at the images on an X-ray machine (X-ray imaging), the doctor very carefully inserts a thin needle into the side of the spine.
- To make sure the medicine is going into the right place, you may need to inject a little bit of a special 'contrast dye'.
- Finally, a steroid injection is given to reduce pain and swelling.
This entire process usually takes less than 30 minutes .
What happens after the injection?
After the procedure, you may feel a warm or "different" sensation in your leg and lower back. You will also notice that the pain is gradually decreasing. Don't worry if your leg feels a little numb or lifeless, as this will completely go away once the painkillers wear off.
You can eat and take your medications as usual. But avoid strenuous activities, lifting weights, or exercising for 24 hours. Take it easy. You can resume your normal activities the next day.
The benefits and possible side effects of this
Benefits
- The pain is temporarily gone, and daily activities can be carried out more easily.
- It reduces swelling in the nerves that cause pain and helps them heal.
- It helps the doctor find the specific cause of the pain.
However, it is important to remember that not everyone will experience pain relief from this injection. If this happens, your doctor will suggest other treatments.
Side effects and complications
As with any medical procedure, there are some risks involved, but serious complications are extremely rare.
| Effect | Description |
|---|---|
| Minor effects that are often seen | |
| Bruising | A small bruise may appear where the injection was given. |
| Swelling | A small swelling in that area. |
| Soreness | There will be a little pain in that area for a few days. |
| Rare side effects | |
| Bleeding | Slight bleeding from the injection site. |
| Dizziness | A temporary feeling of dizziness . |
| Headache | Slight headache. |
| Serious complications that can occur very rarely | |
| Infection | Infection at the site of insertion of the needle. |
| Other damages | Accidental damage to a blood vessel, lymph vessel, kidney, or other organ. |
| Horner's syndrome | A very rare condition that causes changes in the eye. |
How long will this pain relief last?
This is a question that many people ask. But there is no single answer to it. It varies greatly from person to person.
For some people, the pain subsides as soon as the injection is given. However, the pain may return once the pain medication wears off. Long-term relief begins after the steroid medication starts working, which is usually within two to three days. For some, this relief lasts for a few days, for others, it lasts for weeks.
In most cases, to maintain relief, you will need to take several of these injections over a period of time. Sometimes two may be enough, sometimes more than ten. That will be determined by your doctor.
What time should I call the doctor?
This is very important. If you develop any new symptoms after the injection, or if you develop any complications (for example, signs of infection such as redness, swelling, or fever at the injection site, or changes in your nerves such as numbness or tingling in your legs), call your doctor right away.
Take-Home Message
- A Lumbar Sympathetic Block is a special injection given into the lower back. It is used to treat certain pain conditions, mainly in the legs and lower back.
- This not only provides pain relief, but also helps to find the cause of the pain.
- This procedure is usually quick (less than 30 minutes) and safe.
- Results vary from person to person. Some people may need multiple injections to achieve long-lasting relief.
- The most important thing is to feel free to discuss any questions, fears, or doubts you have about this with your doctor. He or she will explain everything to you.
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