Patient Zeng, a 28-year-old male, was diagnosed with “primary hand sweating” in a hospital in Guangzhou for “excessive sweating of hands for more than 10 years” and underwent “thoracoscopic thoracic sympathetic chain dissection”. After the surgery, his hands, upper extremities and trunk above the level of the nipples of the chest and head and face really no longer sweat. He was happy for a few days, but then a new distress appeared: although the upper body was dry, the sweating of the trunk and lower extremities below the level of the nipple was particularly serious, and he often changed several sets of clothes a day and was still immersed in sweat, which seriously affected his life. But Zeng has been suffering for more than a year, compensatory sweating is still not the slightest relief. Later, he learned that the pain department of Jiaxing First Hospital was carrying out the treatment of compensatory hyperhidrosis, so he rushed to seek treatment. The patient was lying prone on the CT table, and the doctor stabbed two fine needles from the back of the patient’s lumbar vertebrae under CT guidance, and injected 3.5 ml of 75% alcohol on each side after confirming the correct position. The patient’s compensatory hyperhidrosis disappeared immediately and was followed up for 2 months without recurrence. According to Huang Bing, deputy chief physician of the pain department of the hospital, compensatory hyperhidrosis, also known as metastatic hyperhidrosis, is a common complication after thoracoscopic thoracic sympathetic nerve chain dissection for hand sweating. The mechanism is that the lower sympathetic chain (lumbar sympathetic chain) loses the downstream inhibition of the hypothalamic sweating center after the thoracic sympathetic chain is completely severed, which leads to a state of uncontrolled sweating in the lower half of the body. Theoretically, re-execution of the lumbar sympathetic chain can effectively stop sweating in the lower body, but the consequence of no sweating in the whole body is quite serious: once the patient completely loses sweating function, 80% of the heat dissipation capacity will be lost, and the hot environment will easily lead to heatstroke, so we cannot rely on lumbar sympathetic chain excision to treat compensatory hyperhidrosis. Lumbar sympathetic nerve chain block is a nerve function modulation technique that inhibits excessive sweating and preserves the normal sweating function in hot conditions without worrying about the risk of heat stroke.