Epidural Sympathetic Nerve Block

A minimally invasive procedure to relieve leg pain

The sympathetic nerves are located on either side of the spine. These nerves normally are involved with involuntary functions, such as:

• Body temperature regulation
• Blood pressure
• Heart rate
• Sweating

After some injuries or illnesses, these nerves can malfunction, causing a condition called chronic regional pain syndrome (CRPS), which can lead to leg pain. In an epidural sympathetic nerve block, we inject a steroid medication near the sympathetic nerves to block or decrease the pain in your legs.

Pain Management Service, Newton-Wellesley Ambulatory Care Center
159 Wells Avenue
Newton, MA 02459
Phone: 617-243-6142

What to Expect From Your Epidural Sympathetic Nerve Block

When you arrive for your procedure, one of our nurses will speak with you about what your leg pain is like and how you manage daily activities. We’ll record the following vital health information:

• Allergies
• Blood pressure
• Brief health history
• Medications you’re currently taking
• Pulse
• Temperature
• Weight

It’s especially important to tell your nurse if you:

• Are allergic to contrast dye, Betadine (iodine), or latex
• Currently take blood thinners
• Have diabetes or could be pregnant

We may start an intravenous (IV) line in your arm. This lets us give you fluids or a mild sedative during the procedure to help you relax. We’ll also apply temperature strips to the tops of your feet. These can help us see if your nerve block is successful during the procedure.

Next, you’ll discuss the procedure with your doctor and go into the X-ray room, where we’ll help you onto a table. Once you’re comfortable, we’ll clean your skin with an antiseptic and numb it with a local anesthetic. Next, your doctor will use X-ray guidance to place a small needle into the epidural space of your spine. We may use a small amount of contrast dye to make sure the needle is in the correct location. Once the needle is in place, your doctor will inject the medication into the joint. The entire procedure will take only a few minutes.

You should plan to stay with us for an hour after your procedure, as the anesthetic can make your legs feel weak or numb. During this time, a nurse will go over any questions you may have and review your discharge instructions and required follow-up care. Due to the side effects of your injection, you will need someone to drive you home after your epidural sympathetic nerve block. You won’t be able to drive for three hours after the procedure.

When You Go Home After Your Epidural Sympathetic Nerve Block

After you return home from your procedure, try to rest and avoid activities that might aggravate your pain. You likely can return to work the next day and return to exercise the day after that.

Some patients experience more pain at first when the anesthetic wears off because the steroid can irritate the nerves. Place ice on your injection site and take over-the-counter pain medications to ease any pain.

You should notice an improvement in your leg and foot pain within three to seven days. Many patients experience noticeable pain relief after their first or second injections. Don’t be discouraged if you don’t notice pain relief after the second injection. You may need to schedule a follow-up consultation or additional injection with your doctor.

Talk to your doctor for more information about receiving a referral for an epidural sympathetic nerve block, or call us at 617-243-6142 to request an appointment.