Dear AJ -

How long have you been symptomatic? The reason I ask is that there is fairly strong evidence that blocks are most effective when initiated within the first four or five months of disease onset.

Although I have absolutely no evidence for this proposition, I have a hunch that one of the reasons I didn't get aggressive spreading was because I was getting regular lumbar sympathetic blocks early on, until I no longer had any response to them, roughly 8 months after the pain first set in. That said, there may be a number of people on the forum who got prompt blocks but to no avail. This maybe worth a poll.

Mike