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The lumbar nerve block is useful for dealing with hard to treat pain syndromes. The target of this block is the sympathetic chain and nerve bundle located near the vertebral bodies of the lumbar spine. The most common site of injection is adjacent to the 2nd lumbar vertebra. Sympathetic nerve blocks can be diagnostic, prognostic, or therapeutic:

. Diagnostic - To determine if the sympathetic nervous system is the cause of pain.
. Prognostic - To determine if a neurolytic (nerve destroying) agent or procedure would help.
. Therapeutic - To provide pain relief for a variety of painful conditions.

If you are on blood-thinning medication, be sure to notify the doctor, as these must be held for several days. In addition, you cannot eat or drink after midnight before the procedure, but are allowed to take necessary medications with small sips of water.

When you arrive at the medical facility, a nurse will go over the procedure and have you sign a consent form. An IV catheter will be placed in your arm for sedation or fluids if needed.

In the procedure room, monitors will be applied to allow the medical staff to track your vital signs during the procedure. Once you are positioned on your stomach, your skin is cleansed with an antiseptic solution, and the doctor numbs you with a local anesthetic.

After the skin is numbed, a needle will be inserted in front of the lumbar spine vertebral bodies, where the nerve mass lies. This is done using fluoroscopy, a form of x-ray guidance, which allows the doctor to visualize inside the body. The local anesthetic (lidocaine or bupivacaine) is instilled onto the nerves, and the needle is then removed.

Once the injection is complete, a small dressing is placed over the injection site, and you are transferred to the recovery room. A nurse will monitor your condition for around 20 minutes. Most patients experience a warm sensation over the leg on the side of the block, but this is temporary, and pain relief follows. If the block relieves your pain, this indicates that the sympathetic nerves are involved.

This block has many benefits, such as:

. It is a minimally invasive technique, which is an alternative to surgery.
. It offers immediate pain relief, which allows the patient to participate in physical activity and daily functions.
. It is a useful technique for diagnosing a specific type of pain.
. It is useful for establishing further treatment measures.

The clinical research evidence supporting the use of this block is substantial. In a 2008 literature review, the researchers noted a strong recommendation with moderate quality evidence supporting the use of this nerve block. Recent clinical studies show that the block has a success rate of around 80%, which applies to CRPS, neuropathy, and other conditions.