Psoas Sheath Block


What is a Psoas Sheath Block?

  • The psoas muscle extends from the thoracic area of your spine down alongside your lumbar spine and attaches to your hip (lesser trochanter). It is joined to the iliacus muscle and together these form the iliopsoas muscle.
  • The iliopsoas muscle is frequently responsible for pain which can radiate from the thoracic spine to the hip area, occasionally extending to the buttocks.
  • A psoas sheath block involves the injection of local anaesthetic and steroid (or Kenacort) into the psoas sheath.
  • The aim of the injection is to reduce inflammation, irritation and swelling around the iliopsoas muscle.
  • This procedure is always performed using an X-ray machine in the day surgery setting. 


Prior to the Procedure

  • All blood thinning products (except aspirin) must be stopped prior to your procedure. You will be advised by letter when to stop taking these medications at the time that your admission date is arranged.
  • You are able to take your other regular medications with a sip of water on the morning of your procedure.
  • If you are an insulin dependent diabetic you will always be at the beginning of the list. Please bring your insulin with you and it will be given to you following your procedure.
  • Hamilton Day Surgery Centre staff will advise you of your fasting and admission times.
  • You must not have anything to eat, drink, smoke or chew prior to your procedure.
  • You will need to organise someone to drive you home after the procedure as you will not be able to drive for 24 hours after your procedure.


What Will Happen?

  1. You will be admitted to the day surgery by a nurse and you will be asked to change into a gown.
  2. The anaesthetist will speak with you and place a cannula (plastic needle) into a vein in your hand.
  3. In the procedure room, you will be assisted to position on the procedure table on your abdomen with a pillow under your hips and abdomen.
  4. The anaesthetist will give you some sedation into your vein.
  5. An X-ray machine will be used to determine where the doctor will place the needle for your procedure.
    • The procedure will take approximately 10 minutes to complete.
  6. Kenacort and local anaesthetic will be injected once correct placement has been established with the use of the X-ray machine and contrast (Omnipaque).
  7. After the procedure, you will be placed on a trolley and taken to recovery, where you will remain for approximately 1 hour.
  8. After having something to eat and drink, you will be discharged with a carer.


Post Procedure

  • Gentle activity and rest is recommended for the first 24 hours following the procedure. You may then return to normal activity.
  • The local anaesthetic will wear off 12 – 18 hours following your procedure and the steroid will take 48 hours to start working.
    • During this time there may be a window of increased discomfort or pain.
  • Occasionally, you may feel some leg heaviness or weakness. This is related to the spread of the local anaesthetic.
    • Should this occur, it is advisable you stay at the day surgery until sensation and power returns.
  • A nurse from the Hunter Pain Clinic will telephone you 24 to 48 hours following your procedure to check on your progress and to organise a follow-up appointment. 
  • You may obtain between 1 - 6 months of pain relief following your procedure.


If you require further explanation of the procedure, please contact Hunter Pain Clinic nursing staff on (02) 4985 1800.


* Image by Beth ohara (Own work) [GFDL ( or CC-BY-SA-3.0 (], via Wikimedia Commons