questions re: lumber sympathetic block
 

Hi All,
I did not realize my last visit to this site was in 12/10. I have RSD in all of my extremities. I have developed RSD resulting from an IV starting in my hands/arms then feet and calves since 6/2007. I had a few GSB and LSB done in the past. With some other therapies such as oxygen therapy, PT/OT and STS, my pain level had gone down tremendously although there was no remission. Unfortunately, i had RSD flares in three of my limbs after a blood drawn about two months ago. I just had a bilaternal LSB done on Monday. I have some relief in burning symptoms on my calves but not too much on top of my feet. The relief only last for about 6 hours. Also i have experienced low back pain after the blocks. My back is still bothering me though it is improving. My questions are: is it normal to have back pains after the block and how long does the pain suppose to last? My doctor told me i should have a serious of 3 blocks. Is it worth the risk to repeat the blocks since my pain relief was only partial and only lasted for a few hours. In addition, i am so scared of the IV or any needle sticks. This time they put the IV in my left arm which is the less painful arm. Now i think i have a little flare on my left arm as well. Lastly, do i have SMP or SIP? This is my fourth years of having RSD.
Your feedback will be greatly appreciated.
Numb

I can't really tell you what you should do in this situation, but I just had serious complications after my LSBs in January. My back hurt really bad after the first one and then after the second pain just exploded in my back and neck, then spread to my arms and hands. When I told the doctor he said that it wasn't normal and that sometimes there is back pain but that it shouldn't last more than a day. If you are sensitive to needles and you're not getting much relief, then if it were me (and it's not so you need to make the best decision for you) I would not continue with the blocks.

But that's something that you should discuss with your doctor. I stopped seeing my PM doc after this because if he couldn't do blocks then he was not interested in looking into other treatments (and he didn't want to admit that my new problems were the result of the blocks he did). Some doctors are more interested in procedures than in doing what is best for the patient. I'm not saying that this is the case with your doc (as I don't know them) but you should really discuss what you are feeling with the doctor before having any more LSBs, even if just for your own peace of mind. After discussing your concerns then maybe he can put your mind at ease and you will feel better about your course of treatment.

Catra, Sorry to hear that you had suffered new pain in your arms and hands after the LSB. Is this new RSD pain resulted from the LSB? If so, how did it happen? Has it been resolved? Thanks for sharing your experience.
My back pain is pretty much resolved. My pain doc did not really discuss my response from my LSB. She said i should have a serious of 3 in order to max the benefit. She is so busy; she can't even do the additional block until 10/11 therefore, she recommended another doctor who is very young and new to their team. I was scheduled to go in today but they needed to cancel me because i forgot to stop taking the mobic and fish oil. Now i had to wait for anther two weeks. By that time, i am not so sure whether or not the 2nd block would help. I am kind of scared of any possible complication. I need to sleep on this one.
This RSD flares make me crazy. I feel like i am starting all over again and i need to bring my pain level down to a more comfortable level. It drains our pocket and i need to take so much time off from work to see the doctors and getting the treatment. Very frustrating indeed!
I suppose i need to pray harder.
Thanks for listening!

Glad to hear that your back pain has resolved. I hope that these blocks help get your RSD pain under control. Hopefully even with the delay, the second block will help you. If you get relief from the blocks then that's really all that matters. But still make sure that you get any concerns addressed by the doctor. Maybe after this series of blocks you can follow up with the doc to discuss the results and benefits/risks of continuing this type of treatment. But if it's successful then that's fantastic and I am really happy for you.

As for my stuff...no luck on getting any of it resolved. Though with extensive physical therapy I am finally on my feet again...a little...and I am working towards getting my life back...again. I didn't get very good care when it all initially happened (stupid doctors giving me the runaround for months on end) but the doctor I'm with now believes that the new pain and spread was related to the LSB. How it happened...who knows? Could be that it caused an infection to get into my blood stream (they performed the first of 2 blocks when I had an active MRSA infection), could be that I ended up with chemical meningitis that went undiagnosed and worked its way out of my system, could just be from the trauma of the needle itself, or could be the result of something I don't even know about (the entire staff there was totally incompetent...even the doctor said so on a number of occassions...so who knows what happened while I was under sedation). But it doesn't really matter anymore HOW it happened I guess as I just need to deal with what things are now.

Numb,

I had several serious of LSB. They are usually done once or week or once every 2 weeks. Mine were every 2. It was minor pain with lots of pressure under slight sedation.
Each shot you should see a little longer and a little longer. If not it is not for you. I started out the same way and after about 12 shots, I only got to 7-10 days.
My Back pain was usually gone within a week, but I am not sure if it is from walking with an exterme gait or the shot, because I still have flairs.

IV pain- there is a cream called "EMLA" that you should ask your doctor for. It is applied prior to the procedure, covered with plastic wrap until your procedure. It is a numbing agent. When I was a nurse in minor surgery, a lot of people said it helped. I have never tried it first hand.
Good luck.
Anita