Dear heartbeatmom,

Ballpark, if you started within just a few months of the time the pain first began, you're in the best position for the blocks to help.

If you haven't done so, check out a study I cited on the first page of this thread, "Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome," Ackerman WE, Zhang JM, South Med J. 2006; 99:1 084-1088 at 1087, free full text at http://www.rsds.org/2/library/articl...lion_block.pdf and in particular Table 2 at page 1086, which shows that in a study of 25 people with CRPS in one hand following surgery for carpal tunnel syndrome, of those who received 3 stellate ganglion blocks over a 3-week interval, those who had complete relief from pain started the blocks within 4-6 weeks of the onset of pain, those who had partial relief started at the 10 - 12.5 week mark, and those who got no relief at all ranged all the way from 11.5 to 65 and 1/2 weeks. Interestingly, although all patients were tested until six months after completing treatment, both of the groups with complete relief and partial relief saw that relief end at the same time: 29 weeks following completion of the 3-round cycle of blocks.

As best I've searched, I can't find any similar studies for lumbar sympathetic blocks, but I would be surprised if it differed much from the S.G.B. study we do have, where nearly the same results occurs (success as inversely correlated with lenght of time between start of symptoms and initiation of treatment) with low-dose ketamine infusions, as set forth in my earlier post of the thread. (In fact, I just came across a study that found that the use of a fish hormone typically used to treat osteoporosis [remind anyone of pamidromates/organophosphates?] is effective in preventing CRPS-1 in stroke patients withe severe paralysis of one side of the body if given within four weeks of the stroke, but not after six. Use of Calcitonin to Prevent Complex Regional Pain Syndrome Type I in Severe Hemiplegic Patients After Stroke, Matayoshi S et al, Disabil Rehabil. 2009 May 19:1-7. [Epub ahead of print) abstract at http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum.)

I know that my first L.S.B. did nothing, but the next time my doctor decided to do a "bilateral" block, which is to say that I got two injections, one on either of the spine. And my pain went into remission for two weeks. And I started at roughly 12 weeks out.

So, if you started the blocks within a relatively short period of time after the pain first set in, the odds appear to be in your favor if you have a third one at least - and it has to be done under flouroscopy so the medication is delivered precisely without damaging any nerves - but I would consider asking your doctor what s/he though of doing bilateral injections.

Hope this is useful.

Mike