[Rolacoy]

Is the only treatment nerve block for RSD? Also pain meds, I guess. I am taking:
• Cymbalta 60mg (to heal nerves)
• Hydrocodon Acetaminoph 7.5-500 (1/2 tablet every 6 hours for pain)
• Methocarbamol 750 MG (1/2 tablet every 6 hours muscle relaxer)
•LYRICA 75 mg, (6 Capsules for Nerve pain)

One of the listed side effects of Cymbalta is elevated blood pressure. I went from 30mg 10 days ago and 7 days ago my blood pressure went from my normal of 124/75 to as high as 154/80. Along with that is a slight head ache, I never have head aches. I am seeing the neurologist tomorrow afternoon. I want to disscuss getting off Cymbalta or at least go back to 30mg.

Two questions:
• Does Cymbalta or Lyrica help the treatment of RSD?
• Is nerve block the only treatment?

[Russell]

Originally Posted by Rolacoy

Two questions:
• Does Cymbalta or Lyrica help the treatment of RSD?
• Is nerve block the only treatment?

I take Lyrica for pain control and to answer your question on nerve blocks used as a treatment I can only say that it was used as a diagnose tool on me.
I was prescribed Cymbalta when I first had my surgery on my left wrist but didn't take it because of the probable side effects.
I recommend giving Lyrica a try...

[catra121]

Lyrica was helpful for me in the beginning (but I am off of it now). Cymbalta...I had a VERY bad reaction to that one but since I was suffering from undiagnosed seratonin syndrome at the time my doctor and I have discussed giving it another try at some point. Neurontin is another one that some people find helpful but it didn't do much for me (too small of a dose I think).

There are a number of treatments for RSD. Nerve blocks are one, SCS is another, ketamine treatments yet another. These are all done in conjunction with physical therapy (which for me has been the best treatment once I got enough pain relief to do it), and usually pain meds too. Add to that the number of things we all do to try to help get some relief on a daily basis like the heating pads, warm bath with epsom salts...etc. It really involves a group of things with no real one and done type of treatment (sad to say).

[Russell]

My biggest problem is having a rod inside my upper arm and a plate across my wrist that get cold. Man the pain! When my RSD decides I'm cold nothing helps...

[Rolacoy]

As I stated I am on both Cymbalta and Lyrica. From what I have read the nerve block will sometimes put RSD into remission. This is effecting my left arm along the nerve C-6 from my shoulder to my thumb and four finger. I am in PT and it is going well.

Should I insist on getting a nerve block?

[Russell]

Originally Posted by Rolacoy

.

Should I insist on getting a nerve block?

That's up to you and your neurologist. It could go either way.
Mine was used for diagnose but it did relieve my pain for a while but now my RSD is spreading.
Of what I hear it may work for you or down the road make things worse.
It's your call...

[catra121]

I agree...up to you and your doc. I did a few and while I had some minor relief of symptoms, the last actually caused my condition to get far worse and was immediately followed by spread of my RSD. That's extremely rare though...so I wouldn't use myself necessarily as the standard. Like any other treatment, it's not necessarily for everyone and there is a small chance of complications. I would definitely discuss it with the doctor as an option and see what he thinks, and if he doesn't think it's a good treatment for you...ask why and what treatment plan he wants to follow. Even if you get the nerve blocks...they are not always successful. My first one only helped with the "coldness" of my leg. The second helped a tiny bit with the pain in my ankle, but I began to have pain in my back and neck, and after the third one my world went to heck and the RSD spread everywhere. Exactly why or how this happened...I don't know...but definitely discuss the details of the treatment with the doctor to find out if it's right for you. It is typically, from what I understand, one of the first treatments they use with RSD (either to diagnose or as treatment).

[Dubious]

Originally Posted by Rolacoy

Is the only treatment nerve block for RSD? Also pain meds, I guess. I am taking:
• Cymbalta 60mg (to heal nerves)
• Hydrocodon Acetaminoph 7.5-500 (1/2 tablet every 6 hours for pain)
• Methocarbamol 750 MG (1/2 tablet every 6 hours muscle relaxer)
•LYRICA 75 mg, (6 Capsules for Nerve pain)

One of the listed side effects of Cymbalta is elevated blood pressure. I went from 30mg 10 days ago and 7 days ago my blood pressure went from my normal of 124/75 to as high as 154/80. Along with that is a slight head ache, I never have head aches. I am seeing the neurologist tomorrow afternoon. I want to disscuss getting off Cymbalta or at least go back to 30mg.

Two questions:
• Does Cymbalta or Lyrica help the treatment of RSD?
• Is nerve block the only treatment?

Everyone is different. Lyrica helped me a lot but felt like I drank a bottle of cheap wine while on it and soon developed arrythmias so had to discontinue.

Regarding nerve blocks, I am assuming you mean stellate blocks for an upper extremity issue? If so, your response may well depend on whether your pain is sympathetic mediated pain (SMP) or sympathetic independant pain (SIP). Mine (SMP) responded well, although short-term, to blocks and so I go in every 4 or 5 months for one or two as they still knock down my pain and associated CRPS symptoms several notches before wearing off after several months. They aren't so bad. I don't like them...but I'll put up with them because they still work, at least right now. Not sure what I'll do when that stops being an option. If you chose that route, you will know after one or three if it is right for you.

Initially (pre-blocks) I was taking 12 vicodin ES per day with little effect. I was not happy. Post-blocks, my doc agreed with me that I would soon blow up my liver at that pace so now have changed to one and one-half Norco per day which has much less tylenol in it. I should add that only the blocks allowed me to make that change.

I did do the Soma's for a short bit but they made me cranky and feel like I needed to chase the dog around the house with a fly-swatter..(just kidding PETA)

[Rolacoy]

I don't quite understand how a nerve block proves anything. Wouldn't a nerve block on a good arm make the arm go numb just as the arm that is effected with RSD?

Also what is the danger?

Do you get the feeling from your doctors that don't want to research this online?

I really thank you all for your comments.

[catra121]

There are different kinds of nerve blocks but the ones I got didn't make anything go numb...they gave me some (small) relief from the pain. There are different medications that they use for the different kinds of blocks. I'm not knowledgeable about the differences to really know, but a successful sympathetic nerve block would show that you have sympathetically maintained pain...which would indicate RSD. As RSD progresses...the pain becomes sympathetically independent pain and the blocks are not successful. They are not successful in all patients either...so like everything else there is no diagnostic test to PROVE RSD. It is a clinical diagnosis based on the presence of specific symptoms.

Dangers of getting a nerve block can include risk of infection, meningitis, and death. Those are what were listed on the sheet that I signed before the procedure but it stated there was less than a 1% chance of that. My RSD spread after my last one...which has made my life horrible since then...so that is a possibility too (though again...very rare). But when you are dealing with RSD pain it is a worthwhile risk for most of us considering the possibility of some relief from the pain.

As for doctors...well...that varies from person to person really. I have seen many doctors who are uneducated or miseducated about RSD, and have no interest in hearing any information from the patient. Then I have seen doctors who tell me it is a bad thing to research stuff myself and do not like the idea that the patient becomes their own advocate with regards to their health. And then I have a doctor like my current one who has seen and diagnosed RSD in a couple of cases (and very early in the process so her patients were able to go into full remission with proper treatment) who is very interested in anything that I am able to tell her about RSD. She is a general practitioner and therefore not the normal ideal person for me to be seeing in that sense, but under her care I have gotten better treatment than I got with 3 pain management doctors and 3 neurologists. And it is because she really cares about my condition and is working with me to get my life back and overcome this awful thing. My physical therapist right now is this way too...she is always interested in hearing more about RSD so that she can help me to better overcome the obstacles I face. So doctors are a mixed bag in that respect, which is why it is generally best to see someone who specializes in it because they won't need to "research online" and will be familiar with the treatment options (generally of course because not everyone who specializes in RSD is necessarily good at treating it).

Have you gone through the RSD Puzzles? I found them very informative in the beginning and since the RSD has gotten worse I have gone back through and have found some great information to bring my new doctor about treatment options and different meds to try.