I started taking Topamax about 5 mos ago for headaches. I'm not 100% sure the are from RSD (knock effect as I've seen it referred to) or from the damage I sustained to cervical spine in my accident. It doesn't help with the neck pain and its even hard to turn my head or brush my hair sometimes too. But whatever was causing them, the headaches were pretty fierce and happening almost daily. Topamax has gotten rid of about 80% of them now at 100mg per day. I have RSD in my leg and unfortunately very little improvements thus far. Trying Ketamine infusions currently for the RSD in my leg. I have tried Lyrica and Neurontin both in the past with 0 pain relief and had horrible side effects. Fortunately this med works! Did you notice any tingling with your fingers as you were tapering up on Topamax too? How long did the blocks last before? Could you do both? My physical medicine doctor has also suggested trying trigger point injections for my neck as well. Have you ever tried them? They may help with the stiffness in getting the spasms to release. I'm somewhat afraid to try it though.