If you are on blood thinning medications such as Warfarin, Nicoumalone (Sinthrome), Aspirin, Clopidogrel (Plavix), Ticlopidine (Ticlid), Apixaban, Rivaroxaban then please contact the Booking and Scheduling Department on 0161 778 2233.
What is a lumbar sympathetic block?
It is an injection of medication in and around the sympathetic nerves in your back, either on the left or right side.
Phenol is a medication that numbs the sympathetic nerves for a long period. The sympathetic nerves control functions like blood flow to the legs, temperature, sweating and the action of internal organs. These nerves can become involved in painful conditions.
Why is the injection given?
The injection helps to control some of the pains in the legs or abdomen.
The injection is also done to help to test and treat if the sympathetic nervous system is responsible for the pain.
How is the injection done?
You will be asked to come to the Day Services Unit.
A cannula (plastic tube) will be placed at the back of your hand. The procedure is done under local anaesthesia (medication to numb the skin). In some circumstances sedation (medication to relax) and other medications such as pain killers can be given through the cannula.
You will be asked to lie either on your side or on your front. The correct site for the lumbar sympathetic block injection is checked with the help of an x-ray machine and marked on the skin.
Local anaesthetic solution is injected to numb the skin. With the help of the x-ray machine, the needle is directed to the correct place. After further confirmation of the correct position with the injection of the dye, the medication (Phenol) that acts on the sympathetic nerves is given.
What are the effects after the injection?
The leg may feel warm and your blood pressure may decrease temporarily.
What are the beneficial effects?
Blocking the sympathetic nerves can reduce the severity of pain, redness and sweating in the leg and improve the blood supply, thereby helping to increase mobility.
The pain relief may take days or weeks to take effect and may not be 100% complete. Some patients may not get any benefit at all. The effectiveness of the block is difficult to predict. In some groups of patients the block helps by reducing the numbers of painkillers that are required to control the pain.
What are the side effects?
As with any procedure there are risks and possible complications.
The most common effect is some pain at the injection site on your back. You may develop a tendency to feel dizzy or faint when you stand up quickly. This effect is expected and is due to the action of the medication on the blood pressure.
There may be numbness and pain in the thigh or groin lasting for several weeks.
Potential side effects
Very rarely the nerves that are involved with movement may be affected. Bleeding, infection and injection into blood vessels and adjacent areas are other extremely rare side effects, which may require specific treatments.
In males, problems with ejaculation may occur when injections are given on both sides of the body. The use of the x-ray machine to identify the correct site for the injection greatly reduces the risk of serious complications.
Advice/precautions
- You will be required to stay in the hospital for at least a few hours or overnight after the procedure
- If you develop fainting or dizzy spells you should be careful not to sit up or stand up quickly and walk too soon
- A follow-up appointment will be arranged so that the doctor or nurse can review the effect of the injection
- You should carry on with your normal activities, try to increase the exercises you have been given and aim to reduce your painkillers if the effect of the injection appears to have been successful
It is very important that you inform the doctor or secretary in the pain clinic at least one week before the injection if:
- You are allergic to any medications
- You have an infection near the injection site
- You think you may be pregnant
- Caution should be exercised if you have had a recent heart attack or vaccination
- If you have been started on new blood thinning medications
Contact Details
Fairfield
Day Surgery - 0161 778 2503
Pain Secretary - 0161 778 3821
Rochdale
Day Surgery - 01706 517132/517133
Pain Secretary - 01706 517705
Date of Review: February 2024
Date of Next Review: February 2026
Ref No: PI_DS_463 (BRO)