30/04/2026
Relief for Peripheral Vascular Diseases (PVD) – A Modern Pain Medicine Approach
Peripheral Vascular Diseases such as Buerger’s disease and Raynaud’s disease often lead to severe, persistent pain, cold extremities, non-healing ulcers, and significant impairment in quality of life. Traditionally, surgical lumbar sympathectomy (open resection of the sympathetic chain) was performed for these conditions, but this approach is now largely obsolete due to its invasiveness and variable outcomes.
At our Pain Medicine Unit, we are successfully treating such patients with minimally invasive lumbar sympathetic neurolysis / radiofrequency (RF) ablation, which is now considered the gold standard.
Why this approach is better:
• Minimally invasive, performed under imaging guidance
• Day-care or short stay procedure
• Significant and often immediate pain relief
• Improves peripheral blood flow
• Promotes healing of ischemic changes and ulcers
• Avoids morbidity associated with open surgery
Patients who were earlier being considered for surgical sympathectomy are now being effectively managed with this safer and more precise technique.
Today’s Clinical Experience:
We performed lumbar sympathectomy (RF neurolysis) in two patients with severe PVD-related pain:
• Case 1: A patient with Buerger’s disease suffering from rest pain and non-healing ulcer reported near-complete pain relief immediately after the procedure, with noticeable warmth in the affected limb suggesting improved circulation.
• Case 2: A patient with severe Raynaud’s phenomenon and disabling digital pain experienced dramatic pain reduction post-procedure, with improved peripheral perfusion.
Both patients are expected to have further improvement in symptoms and vascular status over the coming days.
