Lumbar Sympathetic RFA

Restore Comfort in Your Legs and Feet with Lumbar Sympathetic Radiofrequency Ablation

At Mitigate Pain Clinic, we specialize in advanced interventional pain management techniques to help alleviate chronic pain. Two effective procedures we offer are the Lumbar Sympathetic Block and Radiofrequency Ablation (RFA). These treatments target specific nerves to reduce pain in the legs and feet.

About Lumbar Sympathetic Nervous System

The lumbar sympathetic nervous system is a network of nerves located in the lower back (lumbar region) close to the spine. These nerves are responsible for involuntary body functions in the legs and feet like pain, blood flow and sweating. They play a role in transmitting pain signals from the lower extremities to the brain.

What is a Lumbar Sympathetic Block?

A Lumbar Sympathetic Block is a procedure where a local anesthetic (numbing medication) is injected near the lumbar sympathetic nerves. The goal is to block these nerves from sending pain signals, providing relief from chronic pain in the legs or feet.

What is Radiofrequency Ablation (RFA)?

Radiofrequency Ablation (RFA) is a minimally invasive procedure that uses heat generated by a radiofrequency generator to destroy specific nerve tissues, thereby reducing pain signals from that area. It’s often considered when conservative pain management methods like medicines and physiotherapy have not provided sufficient relief.

Conditions Treated with Lumbar Sympathetic Block

Painful Diabetic Neuropathy: A common diabetes complication causing nerve damage, tingling and pain, especially in the feet and legs.
Complex Regional Pain Syndrome (CRPS): A condition causing severe pain, swelling and changes in the skin of the affected limb.
Peripheral Vascular Disease: Poor circulation leading to pain in the legs.
Post-Herpetic Neuralgia (PHN): Long-lasting nerve pain after shingles in the lower body or legs.
Phantom Limb Pain: Pain felt in a limb that has been amputated (i.e. cut off after surgery or injury).
Cancer-Related Lower Extremity Pain: Pain due to tumors of the lower limb.

How is the Lumbar Sympathetic Block Performed?

Preparation: You’ll lie on your stomach in the operation theater. The skin on your lower back is cleaned and numbed with a local anesthetic.
Needle Insertion: Using X-ray guidance (fluoroscopy), the doctor inserts a thin needle near the targeted sympathetic nerves in the lumbar region. The position of the needle is confirmed by injecting a contrast.
Injection: Once the needle is correctly positioned, the anesthetic medication with or without steroid is injected to block the nerves.

The procedure typically takes about 30 minutes, and you may experience immediate pain relief, though results can vary.

How is Lumbar Sympathetic RFA Performed?

When RFA is applied to the lumbar sympathetic nerves, it aims to provide longer-lasting pain relief compared to the lumbar sympathetic block. By precisely targeting and deactivating the nerves responsible for transmitting pain, RFA can effectively reduce discomfort in the legs and feet.

Preparation: A diagnostic lumbar sympathetic block which has at least 50% relief in pain and/or other symptoms should be done prior to RFA.
Similar to the lumbar sympathetic block, you’ll be positioned comfortably on your stomach in the operation theater and the lower back area is cleaned and numbed.
Needle Placement: Using X-ray guidance (fluoroscopy), the doctor inserts a special needle to the targeted nerve area. The stimulation is done to confirm needle position due to which you may feel some tingling sensation in the lower back.
Heating the Nerve: A microelectrode is introduced through the needle and a small current is passed to generate heat, which deactivates the nerve.

The procedure usually takes about 45 to 90 minutes.

Benefits of Lumbar Sympathetic Block and RFA

Pain Relief: Both the procedures aim to significantly reduce or eliminate chronic pain in the lower extremities.
Improved Mobility: With reduced pain, you may find it easier to move around and perform daily activities.
Reduced Reliance on Medications: Effective pain relief can decrease the need for pain medications.

Potential Risks and Side Effects

While generally safe, these procedures may have some risks, including:

Temporary Discomfort at injection site
Infection, rare

At the Mitigate Pain Clinic, our skilled specialist take every precaution to minimize these risks and ensure your safety.

Conclusion

Chronic pain in the legs can significantly impact the quality of life. Procedures like Lumbar Sympathetic Block and Radiofrequency Ablation offer effective relief by targeting the nerves responsible for pain. At Mitigate Pain Clinic, we are dedicated to providing personalized, state-of-the-art treatments to help you lead a more comfortable life.

Frequently Asked Questions

Pain relief duration varies; patients experience relief for a few weeks.

RFA provides long-term pain relief, but the nerves may regenerate over the time, potentially requiring repeat procedures.

Patients may feel some discomfort during the procedures, but local anesthesia is used to minimize pain.

Most patients can resume normal activities within a day or two, but it's advisable to follow your doctor's specific recommendations.

Yes. Both lumbar sympathetic block and RFA can be safely repeated if the effects wear off and the pain returns. Your pain physician will determine the appropriate timing based on your symptoms.

Yes, patients remain awake and relaxed. Only a local anesthetic is used to numb the area of needle prick.

Success rates are good, most patients report significant pain reduction and improved function. RFA often provides longer-lasting relief compared to traditional nerve blocks.

Serious complications are rare when performed by experienced professionals. Minor risks include bleeding, infection, temporary numbness or allergic reaction to the anesthetic.