Hello All,

I had a SGB yesterday and have a question. In my reading before hand, I learned there are 3 things that can happen:

1. wrong spot, so the block was a failure
2. right spot and relief
3. right spot and no relief

My main source of pain feels like a burning golf ball just to the left of the cervical/thoracic junction. I think I have a pinched nerve there, but it doesn't show on MRI. I think that's because it doesn't pinch in neutral position. If I laid in bed 24/7 I normally wouldn't have pain....it's being up and about, using my left arm for anything and turning to the left that triggers pain.

I also have some numbness/tremors down the left arm, weird colors (red to black and blue looking )on my arm (but not the classic shiny red), always hot, frequent massive sweats, etc.

The doc knows he hit the right spot......done under fluroscopy and I had the red eye/stroke eye thing.

Neck to arm was numb for several hours, still had my main pain, but greatly decreased. Went to bed when I got home, the numbess from the local was fading, but my left arm felt good ! I could wear my hair down without it driving me insane, still dressed in just a tank top....didn't try to add more clothes.

I must have slept in a funky position because I woke up with severe pain in my 'spot' and massive sweats

Did the SGB not work ? Or did it work until I repinched the nerve sleeping weird ?

My left arm feels normal now (last 5 years has felt numbish.....like my hand felt like I was wearing latex gloves) no heavy ache in chest/axilla/arm. The neck pain is back with a vengence and obviously the sweating did not stop

Is that a successful block or not ?

This was also done for diagnostic purposes and now I'm more confused than ever.

Any thoughts ?

I have never had this type as my condition is in my legs so I had the sympethetic lumbar block which increased my pain. Anyhow first these blocks are not always accurate for diagnosis. Some people do get relief but it is very short. When is your next doctor apt to follow up? I hope soon so you can discuss this and the next step. They may want to do another one or try another type of treatment. Have you seen a neuro? What part of the body was the mri? Are you on any oral meds? I know I am asking a lot of ?'s sorry just can offer better thoughts. Like for ex my condition is legs and eyes/ear. For my leg pain I had an mri of my brain and spine to see if it was coming from there which it was not. Hang in there and I hope you have a doc apt asap to follow up.

Sounds like a successful block - you had the Horner's Syndrome (droopy red eye) and no pain for a period of time in your neck. And your arm feels better. In my experience, my arm usually felt completely painfree for 30 hours or less. I have RSD in my upper right extremity, my neck and my head.

I am fairly certain that your block confirmed your RSD in your upper extremity - it took away your pain. That is my understanding of the interpretation of the blocks and the results.

I believe that my blocks also worked on my RSD symtoms for a period of time. I had a series of 7 of them last winter, and they helped a lot with the facial and chest flushing, cold frozen hands and feet, etc. because they act on the sympathetic nervous system. I remember driving to work one morning and feeling almost "normal." It was awesome - my hands and feet felt OK, I wasn't shivering uncontrollably. Unfortunately, my blocks kept wearing off and I would end up back at square one.

I felt like my RSD was spiraling out of control until I started getting the blocks - they definately chilled me out for a while. Before my first block everything was starting to get numb - my face, my mouth, hands, feet etc. And after the first and second block I could sleep on the back of my head for a night. That was the last time I was able to do that, because that area is much too painful to lie down on. i can only sleep on my left side of my head.

Good luck. I'm sure you'll get a few more answers to your question to help you out.

XOXOX Sandy

What it sounds like to me is that you may have Thoracic Outlet Syndrome. The numbness and tremors and also discoloration comes with the TOS.

What might have happened with the block is that it did help the RSD but you are still dealing with the TOS.

You might go to the TOS forum and read what the people with it go through. I had surgery on my right side around 2000 to take out a rib. I still have the TOS, there is no cure for it but the surgery helped with a lot of the symptoms. It's one of the worst surgeries a person can go through though.

I hope it's not the case for you but it does sound like what you might have. Also TOS will not show up on any test. A lot of Drs. don't even believe in it.

Ada

My experience was simliar to Sandy's. I believe that my 7 helped me immensly too. And by the sounds of it, your blocks were a sucess.

I had 6 SGB's back in May. I had about 75% relief in pain but it all came back after 10 days. I had the Horner's syndrome after each. My dr said they proved RSD (left hand and now whole arm and shoulder) but since the pain came back he doesn't want to do more. He doesn't think they will work any longer than they did. Hope you get relief.

I believe they also look for a temperature increase in the affected extremity to consider it fully consistent for the diagnosis. You probably had this and they just didn't mention it.

Yes, it does sound highly successful. My first one completely eradicated the RSD but lasted only a couple hours. You're supposed tpo exercise during the period of no pain but they often forget to tell the patient apparently. I have little doubt the doctor will want to repeat this procedure for you.

Good luck. It sounds promising.

I have RSD both upper limbs and they have to do 3-4 blocks on each side it always comes back but not as painful and i usually have to go back once a year to get them done every one is different but it took 3-4 years for my doctors to find out what works for me, I get them done every day but other side done until i have had 3-4 blocks done on each arm but it sounds to me that you had a good block but it needs to be repeated GOOD LUCk and I hope you feel better GOD BLESS

Thanks for all of the responses. Haven't been here much recently due to computer issues.

Ada......I do have TOS.......or at least I think I do. I don't have the cervical rib, it was traumatic TOS after an lifting injury. Got the neurontin, antidepressants, and vicodin onboard and can have minimal pain if I don't do anything (you know, like getting dressed and showering), so my neuro said I don't need surgery....plus I would hate to make the RSD worse fro surgery, if I indeed have that too.

Part of my dilemma is that after years of getting called a faker by various WC docs (one of whom mentioned TOS), my neurologist who dx'd TOS,RSD, occipital neuralgia, fibro, ddd,etc is in the middle of a big ol' fraud investigation for declaring a bunch of Boston firefighters permanently disabled, so I am really second guessing everything because I've also had the WC docs telling me there is nothing wrong/it's all in my head, etc

Heck, the pain clinic doc who did the sgb even said it's not RSD because my skin is splotchy red and blue, not shiny red.

I just really want some answers. I'll see what they have to say next week when I'm back at the pain clinic

I wish I could tell you something good about mine.

Had 2- first one- pain relief (maybe 15%) for about 2 days. Second one- nearly died on the table- and I was treated by one of the best in the country.

I'll never do it again.
NOW- some people have wonderful results with no problems- maybe I was the 1%- but it IS risky; the doc has to have a goo flouroscope, and team, and he can't "miss" and inject your veins, as he did me.

If he/she can do that, you're golden, and God willing, they will help you. I will pray that's the case.
Be well and good luck
MDH