Hello Friends!

My question about blocks has a little background.
Dr S., dx'd me in about '90, injury= '83. He hospitalized me and put me through a barrage of tests. (I was the RSD/TOS patient on the floor, that twice a day, he came in with his troop of students, and I did the "TOS TEST" for them all. Hands up, shoulders back. Hands turn white and no pulse.)

I had a "block" that was diagnostic. It made the right side of my face numb, and I think my arm was too.
But, the pain was still there. Dam, said the Dr.! I knew it. It's too late. Dam, said the patient!

I was also sent for lumbar blocks.
They had the same outcome, except, I don't remember any numbness, so I think they were more for pain.

They just didn't work, and Dr S told me not to get any more, for fear of aggravating the rsd.

Now, I notice that lots of you get blocks, regularly.
Some of you like them, some of you don't.
Why?

And, another question, I don't quite get the difference, between type I /II RSD.
I've read it, but it's not sinking in, but does this have something to do with why blocks help some, and not others? (the real question). I know I've gone from Sympathetically maintained to, S. independent... is that it?

Thanks.

I want to express my concern for everyone in the NE, and elsewhere, who are suffering with this weather. Keep tight, say your prayers, and always know, that someone, many, have it Far Worse elsewhere!
We're lucky to be Americans!
(and if you think health care is expensive now, wait 'til it's free!) just a joke...for a lousy friday afternoon....
TGIF!

pete
asb

The difference between type 1 and type 2 is actual nerve damage. Type 1 is no nerve damage and type 2 is nerve damage. Typically those with type 2 will have an EMG done and it'll show that there is nerve damage in the limb that was injured. :-)

Yup, you got the terminology right. You go from SMP to SIP, maintained to Independent.

As for blocks, I was forced by WC to get one a year and 3 months after I was hurt. My pain was already independent by then and had been for quite some time! All it succeed in doing was throwing me into a flare for 2 months with a pain level that hovered around 15-20 every single day. I couldn't lay down, sit down, stand up, walk, etc. LOL I was so glad when it finally went back to "normal."

Hugs,

Karen

Hi Pete
I'm rsd II[causalgia} as Galen said,,I have a nerve entrapment in the back of my r-heel,,The dr's can try to free it up with surery,,but its a low percentage for success,,Thats why they dont elect to do it,,It can make it worse in most cases,,,Ive got to be carefull not to stretch the nerve by dorsa flexing the ankle,,,either way as rsdI and rsd II exercise is our friend,,Rememeber one of my old posts pete? the one you replied to, where the TENS unit made my rsd flare? I wasnt useing it cranked up,,the trapped nerve was being aggravated by it,,,,and the dr;s waited to long to give me the blocks,,,nthen when they did,,,the shots sent me in a flare,,,,because im in SIP,,Plus it's more likely that id be a bad canadate for SCS, for the same reason,,,,,I can find a dr willing to do the surgery to free up the nerve,,If i really wanted to throw the dice and gamble,,but as for right now,,I realy on God to heal me,,He is doing his part,,and im exercising and trying to be faithfull,to do my part,,,,[psalms 41:1-4},, call me sometime pete,,,Id love to hear from you,,,your friend in Christ Jesus our lord and Savior ,,,,,,,,, boyd

Hi Pete
I was given lumbar sympathetic blocks when I was 9 month along, it diagnosed my RSD (again) and helped with some of the pain, some areas of my thigh were usualy numb I found. I was given propofol by IV, a white milky substance to put me to sleep before each block, so it was a nice nap. (yes micheal jacksons sleep med)

They continued with the blocks untill after they no longer helped me at all..
I do feel they helped take the awful thermal freeze out of my foot when it was getting nothing but colder, and I apreciate my doctor later doing bilateral blocks when WCB only wanted to pay for my right leg. We probibly continued them too long, I just wanted them to work so bad.

I also think it should be mentioned that I feel the blocks caused some of the spread to my torso area, particularly my kidney area and up the back, that area still burns since a very specific block procedure. Not that I wasn't in spread mode anyway.. sigh who knows part of me thinks we should all just stop ALL invasive procedures.. A large part.. but I feel like I'd be giving up hope because of my treatments now.. but they too are very invasive.. Sory Pete I am rambling.

There are all kinds of blocks, this is why you have been hearing alot of diffrent things on them.
Not just sympathetic blocks to be given before the RSD pain becomes more centralized.. but prior to this while in the ACUTE stage of RSD, pain is usualy sympatheticly mediated meaning it is delivered through the disfunctional sympathetic nervous system (so they block that nerve see)

my pain was never totaly taken away by sympathetic blocks so it wasn't totaly sympatheticly maintained as they say, I am SIP too, also I was being helped to a minor degree by the sympathetic blocks after one year so I have both centraly or sympatheticly independant pain(SIP) and sympatheticly mediated pain (SMP), or did at @ one year post RSD.

I am in only in my 5th year with RSD and I have it full body including some organs.. I can honestly say it isn't worse than it was when my RSD was in it's ACUTE stage.. as far as mind blowing agony goes anyway. Blocks took that pain down from a 9-10 to a seven that winter and lidocaine and my medicinal herb help too make my life alot more manageable.. find what works for you.. nothing works well for all of us it seems.. and agin I ramble,
hugs pete,
sandra

That is a good question Pete, something I was never too clear on either. Here is what I found, it is from the most up to date Medifocus Guidebook on Reflex Sympathetic Dystrophy.

MsL

I have RSD/CRPS that started in my legs and pelvis , and has since gone "full body" .....

One of my first pain management drs wanted to try a lumbar spinal block for one of my legs and I agreed. However, I only got about 10- 20 % relief, that lasted maybe two weeks--- and I had side effects from it.

I have since switched pain management drs and my current one does not believe any more blocks would be beneficial to me. Because the RSD/CRPS is SIP and what little relief I got from the block, was/is not worth to try again. He thoughts on the LSB's are that they look cool (as in the patients limb change color, etc), but if you don't dramatically improve after one or two, then I don't like them....

Having said that, if your RSD/CRPS is fairly isolated or more severe in one are then another, then blocks can be wonderful. I am glad I tried it though, even though I won't be having any more....

L2L

MSLDAY ~ I am so happy you quoted this....
Now if my brain could digest & methodically understand & speak it.

My pain management doc doesnt want me to have any more TOS surgeries due to the CRPS but how long can my system hold out to Botox Chemodenerviation procedures 4 x's a year for the TOS pain & not increase the CRPS.

I have pretty much full body CRPS 10+ years now including it now affecting my stomach. I read here so many people say it has affected their organs. I can so relate. Its so incredibly frustrating that CRPS cannot be used for my SSDI doc & W/C defense. FM & RSD is not spoken in court & result in approvals these days in California.

Thanks for the info. I have an appt on Monday to talk with the doctor about a nerve block. At least I'll know what he is talking about. I am scared of the nerve block but I need something to give me relief with my feet especially with winter coming.
Hopeful

I too (because of Work Comp) had a series of 3 Sympathetic Nerve Blocks. Just like Karen they sent me into a state of complete pain - Injured Knee went crazy - had to have cortisone injection in my knee. It was awful. My pain doc said "Well, this confirms that your (SIP) Sympathetically-Independent Pain". So now I am trying a trial Spinal Stimulator to see if we can reach that SIP directly. Hope this helps.

HI Pete,
Thanks for this question. I am meeting with a doctor on Monday to discuss a possible nerve block and the information chain you started actually helps me a lot.
Try to have a good weekend!
hopeful