An underappreciated sequelae of deep venous thrombosis (DVT) is the pain associated with
the blood clot in the peripheral extremity. Although most frequently acute in nature, DVT
occasionally presents with chronic pain in the affected limb. Furthermore, many individuals
suffering from prothrombotic states often have recurring pain from DVT. Thus far there has
been a paucity in the medical literature in how to treat post thrombotic pain. Post thrombotic
syndrome (PTS) can cause a significant decrease in quality of life in individuals who have had
a history of a DVT. Symptoms will typically include edema, pain, heaviness of the affected
limb, skin changes, ulcers, varicosities, and gait abnormality. An underappreciated approach
to treating PTS is the utilization of lumbar sympathetic blocks (LSB). A 68-year-old male who
had a history of recurrent right lower extremity deep venous thrombosis presented with
complaints of excruciating pain, discomfort, and erythema in his right lower extremity, which
was negatively affecting his quality of life and prohibiting him from mobility. The patient
attributed his lack of mobility secondary to the thrombotic pain. Compression boot/stocking
therapy was not combating the discomfort associated with the PTS, often increasing the
severity of the patient’s pain. Sequential right lumbar sympathetic blocks were performed,
which nearly completely resolved the patient’s symptoms and improved the patient’s
ambulatory status and ability to perform activities of daily living. Sympathetic nerve blocks
should be considered as a treatment option for patients who suffer with pain from PTS.
Key words: Pain, edema, lumbar, sympathetic, thrombosis, venous