Stellate Ganglion Block and OT
 

I'm having my first stellate ganglion block Thursday as my RSD has spread from my legs to my left wrist now as well. I'm a little freaked. I've had 6 lumbar sympathetic blocks, but having one in the neck is a little more nerve wrecking. I will be given anesthesia, though, thankfully. My doctor was even ready to do the first one at my appointment today if I hadn't eaten breakfast- darn! :p

I've been going to PT for my legs for a very long time and now the past couple months for my wrist as well. But since the PT for my legs isn't as necessary anymore as I have an SCS which is helping with that pain, my doctor mentioned maybe seeing an OT. Has anyone ever seen an OT for RSD in the wrist area? It's my understanding that they work more on functionality and day-to-day tasks, which I am ok with. Sure a lot of stuff might hurt to do, but I can get it done, and my range of motion and strength are decent. Aggressive PT is what really worked for my legs. Would OT be just as aggressive in helping? I'm not sure really where to go at this point.

I don't see why the OT wouldn't be as aggressive if that's what you need as a patient. Since you "know the drill" so to speak with RSD just be open and honest with the therapist about your condition and what you want/need from treatment. If you are completely on board for doing what you have to so that you can maintain the function in your wrist then I doubt you will get any resistance from the therapist.

Hope the block goes well and good luck in therapy.

I personally have seen many many therapists for my hand to my shoulder. DO NOT LET THEM USE ICE!!! Not only does it hurt, it can cause more damage. Limited heat too. It has helped a bit. Chiropractic helped too. Water therapy was good too. Depending on your pain levels, YOU decide how much therapy to do. I suggest not pushing and pushing, go as far as you can handle without making yourself worse then stop. Then rest, repeat. At least, I think. That's what was done for me for years after my wrist was crushed anyhow, and I had to re-learn how to do everything all over again. If you have great pain management going, then maybe you can be a bit more aggressive in your therapy. Just be careful to not overdo it. The neck nerve blocks were good on me; I too had anesthesia and then aggressive therapy after. Just avoid a sympathectomy, there are side effects...

I did OT at Cleveland Clinic. I had rsd in my legs only at that time but it has spread. I did not have good results in PT in general but that is separate and I am not sure about the whole agressive approach either but everyone is different. In terms of OT there they had different rooms and like courses almost of everyday things from doing laundry,shoveling, going grocery shopping etc. Also if you had lets say a hobby you gave up due to this they helped to maybe restart it. You also were supposed to do the items in a proper manner. For example I have other areas that are in pain because I rely on an area or use my body in a wrong manner to protect the rsd pain area.
I think it is so key who ever you work with deals with RSD a lot and maybe you can even speak to a couple patients.
Hope you get relief

Good luck Yellow!!

I had stellate ganglion blocks when first diagnosed with RSD in the right side of my face. They did a series of them aggressively, without anesthesia, and in conjunction with medication I went into remission for 13 years. Had a big flare up in 2005, when treated with meds it calmed down. Then in 2009, I injured my right hand and was not properly diagnosed, RSD set in, too late for the blocks to help much although we tried them, quite a few of them!! One of the dr's did them with anesthesia and it was nice at the time because it helps you relax. The RSD has since spread to my other hand, arm (due to surgery), left leg and possibly going into my right leg now.

Anyway, I think the stellate ganglion blocks are definitely worth trying if the dr is good and hits the right spot! For me, PT was not helpful at all - it was pure torture!! Could not even tolerate the desensitization with a cotton ball. Ice, heat and a tens unit?? Forget about it!!

The only thing helping me now is my two SCS (cervical and thoracic). Glad yours is helping your legs now.

Good luck with the block Thursday and let us know how it goes. Also, let us know if you decide on OT and how that goes.

All the best,
Nanc
:hug:

I had 11 stellate ganglion blocks (without anesthesia) and they helped a bit. I had a good OT who helped bring my hand back from atrophied and immobile to useful. The primary techniques that my OT used were scrubbing and loading. I spent hours every day working on it & fortunately I was able to get use of my hand back. I wish you the best of luck.

Linmarie
:)

11? nice, i was allowed 6 total then my sympathectomy, which failed after my former job made me work 100% normal with my bad arm even against doctors orders. Therapy had started to be helpful before that.

Definately keep up with the blocks if you can, pain meds, the works. My arm is atrophied badly now, it barely feels ok as long as it is bent up against the chest - no that doesn't stop the pain and spasms, but it slows the swelling and discolorization.

Congratulations on the hand use too :)

Thanks for the replies. I had my first block this morning and it was pretty easy. Luckily I don't remember anything about the actual injection going in. Thank goodness for anesthesia :) I noticed how my hand was much warmer right away instead of freezing cold. I still have pain, but it's somewhat less and the burning and the sensitivity feel better from it. I'm hoping that by catching it early enough in my wrist, these blocks can actually do some lasting good.

I got the name of a physical therapist who specializes in hands and works with RSD patients from a therapist where I used to go, so that should be a good compromise for what I need, but he's a pretty long drive away. I'll let you know how it goes with him, though, I'm hoping he's good and worth driving that far to!

Yellow, I'm glad the block went well. It sounds like it was effective if you noticed your hand being warmer. At least, that is what I was told during my blocks. I hope your therapist can help. In my experience, it has been worth it to travel farther for better care.

Kheldar, the blocks were still giving me improvement so the doc kept on going at two a week until I wasn't noticing additional benefit. Sorry, to hear about your arm. My hand is still atrophied (not as bad as it was) but I work everyday on trying to use it as much as a normal person would. The docs use the word "amazing" that my hand improved as much as it did. My intention at telling you this is to give you & Yellow hope.

Linmarie
:grouphug:

Glad things went well this morning Yellow, it sounds promising! That warm feeling is definitely a good sign, it means they hit the right spot :) I hope you continue to see improvement since they are catching it and treating it early!!

If you get good results from the new PT, then he will surely be worth the drive. Sometimes it's what we have to do to get the proper care...the pay off is great!

Nanc
:hug:

Thanks. I had a total of 6 nerve block shots way back when and had the most (temporary) relief ever, with very very intense therapy right after. Unfortunately I am well beyond that stage now, what with the sympathectomy surgery and now increased symptoms and pain.

Yellow, a piece of advice - don't let them stop at 3 months on therapy either, as most do. I am assuming this therapist knows well about RSD and all, just make sure he/she is willing to work with you as long as it takes!!! And best wishes.