Thank you so much for all your input. It is very much appreciated. My wife had her first Stellar Ganglion Nerve Block today. We are not sure how to interpret the results. She went into the procedure with a pain level of 3 and left with a pain level of 4. She also left with a slight red streak going down her hand that was hurting which she has not had previously. So the nerve block did nothing for pain. But I am curious why her hand with the RSD, which has been cold was now significantly warmer than her good hand. I assume more blood is now flowing into the RSD hand. We were so disappointed in the outcome of no reduction of pain Nurses and doctors were all touting how wonderful the block would be and how some wake up from the procedure with no pain and can move their fingers. While it is wonderful for many, it did nothing for us. We also expected more since the injury happened a little over 2 months ago. So we are sad. The doctor wants to try another block next week to see if we have a better outcome.

This is similar to what happened to me with the very first block I had (lumbar sympathetic block since my RSD was at the time only in my left ankle). My leg turned a deep red and got warmer...but my pain was not reduced. I was told since there was a change in temp and color that meant that the block was successful...but my pain was not reduced so that doctor did not want to do any more blocks. A year later I had to find a new doc when that doctor decided to retire and the new one wanted to do a series of blocks because he thought that the build up of the meds in my system would maybe reduce the pain. Don't lose hope though...this early on she definitely has a better chance for remission. Maybe the next time they will try a slightly different spot or slightly different meds/doses...and you may see better results.

How is everything else going? Is she doing any physical therapy, find a combinations of meds that help, etc? I know it is disappointing when you put so much faith in something and then having nothing to show for it. This was how I felt after that first block. I fought so hard with the insurance company to get it and then when I did...nothing. I actually cried right on the spot because I was so disappointed. But you just gotta keep focusing on the good things and know that if this doesn't work you're on to the next thing.

I to have bilateral lower extermity rsd and can say I have many lumbar sympthatetic blocks. none that last. But my foot turns bright red and warm, which gives me more ability to move.
My shots were all 2 to 3 weeks apart, until this last episode. We did one week apart and the first one I had no pain improvement the 2 I had minor improvement. The third one, I got to wear a real shoe for several days, with decreased pain.
Don't give up, try the series. Everything is still early. It would help if she was in occupational therapy.

Warming of the extremity is an indicator that the block was on mark. She should have also experienced a temporary Horner's syndrome (Google it). You are in a good time frame to be treating with SGB's so I would continue with multiple blocks. I started with SGB's at 8 weeks post-surgery and started to notice progressive relief after 5 or 6. My results peaked probably around number 9 or 10 but continue to go back every 4 or 5 months for one or two when my symptoms degrade. I have had a total of 17 or so now but they still work for awhile after each series so for a bit, I am happy as pigs in slop.

The fingers stiffness could just be a residual from immobilization, unrelated to CRPS, that will resolve with PT. BTW, physical therapy is essential at this point especially after blocks. Unless there is a reason to do otherwise, she should try to use the hand as normally as possible to help regain function and avoid contractures (which perpetuates more pain and dysfunction).

I highly recommend Parafin dips. Either through therapy or on your own. Make sure if you do it on your own to really try and manipulate her fingers while the wax is warming her hand. Good Luck to you both

Hi, Thanks again so much for all your comments and ideas. It is very much appreciated as we try to make the right decisions. We had our 2nd nerve block today. While last week's Stellar Ganglion Nerve Block made the pain worse but did create a warm hand with the droopy face, today's was more successful. For the first time since the accident in mid-Sept, she is able with alot of painful effort to have the tip of her thumb touch the tips of all her fingers. That is a huge success since she has not been able to move two of her fingers. She was also able to sign her name using 3 fingers comfortably. But as each hour passes, she can feel more and more pain returning and getting more difficult to touch the thumb with the other fingers. Someone asked what else she is doing for treatment She is doing physical therapy 3 times per week with a certified hand therapist, ear acupuncture from an acupuncturist who has a personal interest in treating RSD, takes Lyrica, clinodine patch, daily parifin dips or epson salt soak for the hand, and hand exercises throughout the day. One of the most useful things she does when she goes to sleep is wraps her hand with globs of Topricin in saran wrap. This seems to take away alot of pain during the night. Our next nerve block is scheduled for Monday. We are hoping to get a little more mileage out of this one in fear the doctor will stop performing these nerve blocks. Thanks again for all your comments. Jerry

I am so happy to hear that the second block was more successful. I pray that the effects just last longer and longer. Sounds like you are on the right track with treatment so that is wonderful. You are a great person to stick by her and support her throughout all this. We don't always take the time to acknowledge our loved ones for their support...but it means a great deal to us when we are suffering so much. Please keep us posted on how things go...I hope she gets some long term relief with all the things she's got going on right now with treatment.

Hi,

I am so sorry to hear about your wifes injury to her hand. My adult daughter developed CRPS resulting from surgery to her hand and arm in
2008. I offer one word of caution. My daughters surgeon suspected right
off the bat she was developling CRPS so within a few weeks he sent her to
a pain doctor who gave her a nerv e block. She did not seem to have
a postive reaction and because of this the pain doctor did not believe she
had CRPS and so much valuable time passed before an nerve conduction
test confirmed CRPS. Thirteen or fourteen months passed before she
received another neve block, the second one helped with some of the pain
but due to the length of time passed it harms her changes.

I am glad her doctor is going to try another block soon. So many doctors
use the prodedure to see if there is reaction and if not thinks the patient does not have CRPS.

Good Luck with the next one.

Joydee