Lumbar sympathetic block with local anaesthesia
A targeted block of the sympathetic nerve chain in the lumbar spine — used to treat lower-limb complex regional pain syndrome (CRPS), peripheral vascular pain and selected neuropathic pain syndromes.
Led by Dr Arul James (Consultant in Pain Medicine, GMC Specialist Register) at The Vesey, Sutton Coldfield. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). Same-week appointments typical.
Who this procedure is for
- Lower-limb complex regional pain syndrome (CRPS type I or II) — typically as part of an MDT plan with physiotherapy and pain psychology.
- Peripheral vascular pain where revascularisation is not possible.
- Phantom limb pain after lower-limb amputation.
- Selected refractory neuropathic pain in the leg.
How the procedure is performed
Fluoroscopy-guided placement of a fine needle onto the sympathetic chain at L2 or L3. Contrast confirms correct spread along the chain, then local anaesthetic is delivered. A positive block produces warmth and a temperature rise in the leg measured by a skin probe. Procedure time 25–35 minutes; visit 90 minutes including recovery and skin-temperature monitoring.
Before, during and after
- Before: light meal allowed. Bring loose clothing for skin-temperature monitoring on the leg.
- During: prone, awake, with local anaesthetic. You may feel pressure but the block itself is not painful.
- After: the leg becomes warm — this is the desired effect and confirms a successful block. Mobilise gently from 30 minutes post-procedure.
Recovery and aftercare
Hydrate well — transient postural blood pressure changes are common for 24 hours. Restart your usual rehabilitation programme the next day. Each block typically provides 1–3 weeks of analgesic effect; a series of 3–5 blocks at fortnightly intervals is the usual diagnostic-therapeutic protocol for CRPS.
How many blocks will I need? +
A diagnostic protocol typically involves 3–5 blocks at fortnightly intervals to determine whether you are a responder. Responders may continue on a maintenance schedule; non-responders are reassessed for alternative interventions.
Can I drive myself home after the procedure? +
No. Transient postural hypotension is common for several hours after the block. Arrange a driver or taxi for your journey home. You can usually return to driving the following day.
Is this procedure available on the NHS? +
Lumbar sympathetic blocks are available on the NHS for CRPS but waiting times can be long. Private access at The Vesey typically means treatment within days of your initial consultation rather than months.
What should I expect in the days after the block? +
The blocked leg will feel warm and may appear redder than usual — this is the intended effect. Mild low-back soreness at the injection site is common and usually resolves within 48 hours with simple analgesia. Most patients notice the analgesic benefit developing over 24–72 hours.
Pricing at a glance
Initial consultation £260. Image-guided lumbar sympathetic block from £900 including consent, image guidance, drugs, recovery and skin-temperature monitoring. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
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Risks and side effects
Common: brief site soreness, transient postural hypotension. Uncommon: vasovagal reaction, leg numbness if local anaesthetic spreads. Rare: bleeding, infection, intravascular injection (minimised with image guidance), allergic reaction.
When this procedure is not appropriate
Uncorrectable bleeding disorder, active local infection, severe systemic illness, allergy to local anaesthetic.
Cost and pathway
Initial consultation £260. Image-guided lumbar sympathetic block from £900 including consent, image guidance, drugs, recovery and skin-temperature monitoring.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with Dr Arul James
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
View the full pain management pathway →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727