Lumbar sympathetic blocks (LSB) result in the interruption of the sympathetic efferent fibers to the lower extremities with sparing of the somatic nerves, thus providing a diagnostic value as to the relative sympathetic contribution to the patient’s pain syndrome. In those patients with significant sympathetically maintained pain, repeated blocks may provide a therapeutic value and help facilitate physical therapy. The original described technique is the paramedian or “classic” approach described by Mandl in 1926. A more lateral approach was later developed by Reid and colleagues. The incidence of complications related to lumbar sympathetic blockade is minimal. The complications result either from insertion and manipulation of the needle or as a direct result of the injected solution.
