Hey there. Not to worry, sorry you're feeeling so uncomfortable. If it's any consolation, the 2nd and 3rd year of my CRPS were the worst, by far, which sounds like where you've landed. In time, the pain seems to lesson up a bit, or it did for me. Then again, the periodic infusions of Zometa from my pm doc didn't hurt either.

As to the questions you pose, there can definitely be a point of deminishing returns with blocks. For a short article written for the lay reader, anand published last years in the RSDSA review, check out "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

And as far as pain treatment at the Mayo Clinic is concerned, while I grew up in Rochester and my parents still live there, I've been badly disappointed on the two occasions I've gone back to be seen for the RSD/CRSP: as opposed to virtually any other health condition. Without boring you on all of my personal details, it was made clear to me that last time I was there that the only way they would actually treat me was if I lived in the immediate area, so they could follow up with me on a regular basis. (This was in 2006.) That said, throughout Southern Minnosota, Western Wisconsin and four communities across Northern Iowa (Armstrong, Decorah, Lake Mills and Waukon) the Mayo Clinic has small wholly-owned feeder clinics, known collectively as the Mayo Health System. Here's the webpage for the Iowa clinics: http://www.mayohealthsystem.org/mhs/...MHS&stateid=IA and the homepage of the Mayo Health System is here: http://www.mayohealthsystem.org/mhs/....cfm&orgid=MHS

If one of these four Iowa clinics is close by, you just might qualify for Mayo Clinic pain treatment as a local, through the Division of Pain Medicine, which I was advised the last time I was there could include "low dose" ketamine, either on an outpatient basis or in a 5-day inpatient infusion, more likely than not starting with an in-patient lidocaine infusion, assuming that you don't have any conflicting health conditions, primarily problems with your heart. That said, here is the webpage for the Mayo Clinic's Division of Pain Medicine: http://www.mayoclinic.org/anesthesio...t/painmed.html As you can see, it's pretty conservative, and apparently relying significantly on it's behavioral pain therapies and chronic pain management programs (a 3-week program not unlike that of the University of Washington in Seattle that attemp to teach techniques of simply dealing with chronic pain without resort to opioid medications (a famed peripheral neurologist at the Clinic, Peter J. Dyck, MD has for many years been a real hawk on the use of narcotics for chronic non-cancer pain) as well as listing two other techniques which have now become somewhat controversial/disfavored, chemical denervation and radiofrequency ablation.

To be entirely honest, and in light of my own personal experience, were I reborn in your shoes, I might think about the Cleveland Clinic instead. For some information on that I put up the other day on that, under the "Radio Frequency Injections???" thread, you might want to check out my post # 12 dated 10-24-09 at http://neurotalk.psychcentral.com/thread105973-2.html

Good luck sorting this all out. And feel free to keep firing away with any and all questions, that's what we're here for.

Mike