Lumbar Sympathetic Neurolysis
Long-lasting relief for lower extremity pain and vascular conditions
About Lumbar Sympathetic Neurolysis
Lumbar sympathetic neurolysis is a specialized procedure that targets the lumbar sympathetic chain, a network of nerves located along the front side of the lumbar spine. These nerves are part of the sympathetic nervous system, which controls many involuntary functions including blood flow to the lower extremities. By precisely injecting a neurolytic agent (typically alcohol or phenol) into this nerve chain, the procedure disrupts or destroys these nerve fibers, providing long-lasting relief for certain pain conditions and vascular disorders affecting the legs and feet.
Unlike temporary lumbar sympathetic blocks that use local anesthetics, neurolysis offers more durable pain relief by actually modifying the nerve structure. This makes it an important option for patients with chronic conditions like complex regional pain syndrome (CRPS) of the lower limbs, peripheral vascular disease, or certain types of neuropathic pain that haven't responded adequately to other treatments.
Extended Relief
Provides longer-lasting pain control compared to temporary blocks
Minimally Invasive
Performed as an outpatient procedure in most cases
Improved Circulation
Can enhance blood flow to the lower extremities in certain conditions
Who Can Benefit
Lumbar sympathetic neurolysis is particularly beneficial for patients with:
- Complex Regional Pain Syndrome (CRPS) affecting the lower limbs that hasn't responded to other treatments
- Peripheral vascular disease with severe pain, particularly pain at rest or non-healing wounds
- Certain types of neuropathic pain in the lower extremities not adequately controlled with medications
- Patients who have experienced significant but temporary relief from diagnostic lumbar sympathetic blocks
- Individuals with hyperhidrosis (excessive sweating) of the lower extremities in select cases
Dr. Hemani will conduct a thorough evaluation to determine if lumbar sympathetic neurolysis is appropriate for your specific condition. This typically includes reviewing your medical history, previous treatments, and often performing a diagnostic lumbar sympathetic block to assess your response before proceeding with neurolysis.
Expected Effects and Side Effects
Lumbar sympathetic neurolysis produces several characteristic effects and potential side effects that patients should be aware of:
Expected Effects (Signs of Successful Block)
Increased Skin Temperature
The affected leg will typically feel warmer due to increased blood flow from vasodilation.
Improved Color
The leg may appear pinker or redder than before due to increased blood flow.
Reduced Sweating
Decreased sweating in the affected leg is common and indicates successful sympathetic blockade.
Pain Relief
Reduction in pain, burning sensations, and hypersensitivity in the affected leg.
Potential Side Effects
Back Pain
Temporary soreness at the injection site is common but typically resolves within a few days.
Genitofemoral Neuralgia
Rarely, pain in the groin area may occur if the genitofemoral nerve is affected.
Orthostatic Hypotension
Some patients may experience temporary low blood pressure when standing up.
Ejaculatory Dysfunction
In male patients, retrograde ejaculation may occur but is usually temporary.
Serious complications are rare when performed by an experienced physician using imaging guidance. These may include bleeding, infection, nerve damage, or kidney injury. Dr. Hemani will discuss all potential risks with you during your consultation.
Frequently Asked Questions
Schedule a Consultation
If you're suffering from chronic leg pain, Dr. Hemani can help determine if lumbar sympathetic neurolysis is right for you. Contact us today to schedule your consultation.
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Learn MoreMedical Disclaimer: The information provided on this page is for educational purposes only and is not intended as medical advice. Please consult with Dr. Hemani or another qualified healthcare provider for personalized medical advice.
