The steroid injected reduces swelling and inflammation by bathing the painful nerve root, which may reduce pain, tingling, numbness, and other symptoms caused by nerve inflammation, irritation, or swelling. The steroid we use is dexamethasone. The procedure is performed under live x ray and with the use of x ray dye to ensure accuracy and precision. The procedure involves cleaning your skin with an antiseptic solution.. The procedure is done under local anesthesia, so you are not “put out” for the procedure. The procedure is performed while you are lying on your stomach. You are monitored with a blood pressure cuff and a blood oxygen monitoring device which monitors your oxygen levels and heart rate. Immediately after the injection, the skin is cleaned and a band-aid is applied. You may experience some “pressure” at the injection site and this may last up to an hour. Your pain may return and you may have a “sore back” for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself. At about day #3 you should start noticing pain relief. It may take up to 2 weeks to notice an improvement from the steroids. Generally speaking, the procedure is safe; however, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain- which is temporary. The other risks involve spinal puncture with headache (post dural headache), infection, bleeding inside the epidural space with nerve damage, worsening of symptoms. The other risks are related to the side effects of cortisone, which include weight gain, increase in blood sugar (mainly in diabetics), water retention, and suppression of the body’s own natural production of cortisone.
How is the lumbar sympathetic block performed?
It is done with the patient lying on stomach. The patients are monitored with EKG, blood pressure cuff and an oxygen-monitoring device. Temperature sensing probes may also be placed on your feet. The lumbar sympathetic block is performed under sterile conditions. The skin on back is cleaned with antiseptic solution and the skin is then numbed with a local anesthetic. Then X-ray is used to guide the needle or needles into the proper position along the outside of the spine. Once in place, a test dose of dye is used to confirm that the injected medication will spread in an appropriate area. If this is okay, the injection takes place gradually over several minutes. The physician will use the X-ray to evaluate the spread of the injected medication. When a sufficient area is covered, the injection will be over. When done, the needle is removed and a Band Aid is applied.
Very rarely the prolapse disc may press on the central area of nerves known as the cauda equina. The patient may experience sciatica down both legs, which may be associated with numbness of both legs. The condition is particularly urgent if there is numbness around the anus and/or genital area, indicating potential or actual damage to control of the bladder and/or bowel. Cauda equina syndrome is a surgical emergency and if patients have any concerns about this they should consult their doctor without delay, as emergency surgery may be required.