Lumbar Sympathetic Block
A lumbar sympathetic block targets the sympathetic nerve chain running alongside the lumbar spine — the division of the autonomic nervous system that contributes to certain types of chronic pain, including complex regional pain syndrome (CRPS), vascular pain, and some forms of neuropathic pain.
How the Sympathetic Nervous System Causes Pain
In conditions like CRPS, the sympathetic nervous system becomes pathologically involved in maintaining pain — a phenomenon called sympathetically maintained pain. Blocking the sympathetic ganglia interrupts this cycle and can provide significant, sometimes lasting, pain reduction.
Conditions Treated
- Complex Regional Pain Syndrome (CRPS) — Type I and Type II; lumbar sympathetic blocks are a first-line interventional treatment for lower extremity CRPS
- Peripheral vascular disease — Pain and ischemia from poor arterial blood flow to the legs
- Raynaud's phenomenon — Vascular spasm causing discoloration and pain in the feet
- Phantom limb pain — Pain in a limb after amputation
- Hyperhidrosis — Excessive sweating of the lower extremities
- Herpes zoster (shingles) pain — Sympathetic component of post-herpetic neuralgia
The Procedure
Under fluoroscopic guidance, Dr. Rubin places a needle alongside the anterolateral surface of the L2 vertebral body — the location of the lumbar sympathetic ganglion chain. After contrast confirms correct positioning, local anesthetic (and sometimes steroid) is injected.
You may notice warmth in the affected leg immediately — a sign of increased blood flow confirming successful sympathetic blockade.
After the Block
A series of lumbar sympathetic blocks is often used for CRPS, typically 3–6 blocks spaced weeks apart. Each block can build upon the relief of the previous one. Some patients achieve long-lasting or permanent relief; others require periodic repeat blocks.
Contact Us
Call 516-492-3100 to discuss lumbar sympathetic blocks for CRPS or vascular-related leg pain.