A sympathetic block is generally the first treatment they try. It certainly has much less risk of causing more problems than PRF...less than 1%. My last one caused mine to spread...but that is EXTREMELY rare (probably like 1% of the 1% that have complications will have this) and I think it is definitely much safer than many other treatments. Even in my case...it didn't make the pain in my ankle worse but the trauma from the needle caused it to spread to the site of the injection and then it spread from there. It is not an injection at the site of the CRPS, which is why is will not aggravate the pain in your CRPS limb.

Has my CRPS improved? Hard to say...but I CAN say that with physical therapy and proper treatment that I am a much better functioning person and I have a much better quality of life. With a routine and a bunch of things that I do to help to ease the pain, I am doing much better. The pain is still there...at its BEST it's at a 5 out of 10 and most of the time is a 7-8. But the movement and function of my CRPS areas is much much better. I have to make myself do things and I would say that my sense of "normal" is now adjusted to the higher pain levels. I have learned to cope with the pain better so that it is no longer the first thing I think about. It's there...but I use a lot of energy to distract myself as much as possible so that I am not dwelling on that constant pain. Instead, I've learned to recognize what triggers the pain and when it is starting to get worse and then I focus on the things I can do to ease the pain instead of the pain itself. Does that make sense? It's like I acknowledge the pain but I don't let it take control of me. I am not my pain. There are still bad days of course...but even on those where I have to take it easy because the pain is too much for normal activities I still focus on the things I CAN do vs the ones I can't do.

The key thing is to try to get your pain to a level where you can consistently do the physical therapy. If you do get a sympathetic block, you want to start doing the physical therapy as soon as possible while you have relief (assuming you do get relief from the block). You will probably have to start small with things as simple as trying to straighten your leg while sitting...or if you can't fully straighten the start with just going as far as you can and doing repetitions of 5-10 to start and increasing as you can. Obviously a physical therapist may be able to give you more specific things based on where your problem areas are.

If you cannot walk much then you have probably lost a lot of muscle (I know I did) so I had a lot of things to do for BOTH legs to get the strength back in both of them while also improving the function in my CRPS areas. My therapist told me to do activities with my hands that required fine motor skills and precision to get those back in shape (because I have CRPS in my hands too now). It hurts...but at least I can use my hands and I am very thankful for that. If I didn't make myself move them I think they would stiffen up and become useless. Use it or lose it...I just keep repeating that to myself when I am having a difficult time.

Just realise it is a long, slow process. Day to day I didn't see much progress but every week my physical therapist was impressed that I could either do something that I couldn't do the week before or that I was so much better at something I just tried for the first time the week before. These are the small wins you need to celebrate to keep yourself from getting frustrated. 6 months ago I couldn't stand or walk at all and now I can walk for several hours at a time with my walker...that's HUGE...but it didn't happen overnight. Even 2 months ago I could barely walk for 5 minutes in a row.

You just need to go at your own pace, but continue to push that enevelope a little farther...adding even just one repetition a day or a minute a week to your walking time or 10 seconds to your standing time at the counter. My physical therapist was excellent for helping me with this, pushing me just enough but not forcing me to do things that I couldn't handle. She came to my house at first twice a week and then once I was running out of visits we switched it to once every two weeks (which she only allowed me to do because I was clearly doing the work on my own in between visits based on my progress). Having someone who could come to the house was great because then every exercise I had was something I could do on my own, as opposed to an outpatient center where you may not have access to that equipment every day.

It has been such a mental boost for me too, finally heading in the right direction after months and months of continuing to get worse while I was shuffled from one doc to the next. It is much easier to make yourself do things when you can SEE the progress and you are getting BETTER instead of worse. Much easier to keep up that fighting spirit.

So...if I were you I would ask myself, "What do I need to do to improve my body's function?" Answer: physical therapy...geared towards specifically improving that function and set of from someone with CRPS. And what do you need to do to be able to DO that physical theray? Answer: get the pain to a manageable level. What steps you take to accomplish this is up to you and your doctor. Sympathetic blocks are a good place to start. Managing medications is also important. If the PRF is something you want to try, then that is up to you.

What I did when I decided to switch doctors when I realized the ones I was working with were not helping me is I wrote out a set of goals that I took in to the new doctor. Based on MY goals, we came up with a plan to address the problems. As we cross one thing off the list, we move on to the next or add a new one. This helps me to get my thoughts organized and focused, and it helps my doctor understand what my needs are. I didn't just want to live with things the way they were...I did not want to spend my life in a wheelchair overwhelmed by the pain. When I was working with a doctor with clear goals, that's when I started to get better. Maybe this would be a good idea of something you can do with your current doctor. This way you can see if PRF is really the right step to help you meet your goals or if there is something else that might be better to help you get there. Making it clear to the doctor what you want from your treatment can make it easier for them to assess if the risks of different treatments are in line with what you are expecting to get out of that treatment.

Sorry to go on and on...I just feel very passionately about all of these things. I realize that not everything that works for me will work for the next person...but if even one thing I can say helps even one person then it is worth it to say. Besides...typing is good exercise for my hands.