Dear erosati -

Pardon me if I am direct, but to diagnosis you with a presumably fresh case of RSD in your foot - I presume you have had the symptoms for less than four months - and not recommend an immediate series of lumbar sympathetic blocks, IMHO borders on criminal negligence, where an aggressive round of blocks very early on can knock out the RSD, whereas later on they are useless.

By way of background, sympathetic blocks are essentially injections of large amounts of local anesthetics near your lower spine (sometimes containing a steroid such as Kenalog) while the doctor is guided at at times by a flouroscopy machine: so the needle doesn't make contact with anything that it shouldn't. For a (very) short piece that was written last year for the RSD/CRPS community in the RSDSA Review, see, "Clinical Q & A: Can there be too many sympathetic nerve blocks for the treatment of CPRS?" by William E. Ackerman, III, MD at http://www.rsds.org/1/publications/r...inter2008.html But please note, in order for blocks to really work, they must be taken in conjunction with physical therapy: like it or not.

Which is whys why it's so important that you do everything in your power - right now - to obtain whatever financial assistance is concievably available to you: the alternatives are not pretty. So, if cost or insurance is an object, I would be filing an application for Medicaid, etc. as fast as humanly possible, or seeing an attorney if you have any claims to pursue against another party on account of your underlying injury.

Time is really of the essence here. Please make the most of it. Any questions, let us know. Good luck!

Mike

PS If you're looking for a good pain management specialist in your area, I would check out those doctors who have been certified by the American Board of Pain Medicine. This is a group which has, as part of it's mission, the development of "standards and requirements for graduate medical education in Pain Medicine in collaboration with other concerned organizations and agencies," e.g. that they supervise standards in residency and fellowship programs across the country and they in turn certify only pain management psysicians who meet their educational (residency and/or fellowship) standards, and pass an 8 hour written exam. To use their search engine to find someone in your area, go here: http://www.association-office.com/ab...dir/search.cfm