I go in for nerve blocks on Thursday..... My doctor says if this doesn't work she is wanting to burn my nerve endings..... Is this a good thing??????

Hi Bronco.
I had nerve blocks which were unsuccessful for the condition in my knee. Lignocaine (lidocaine in U.S.) & Guanethidine. The doctor doing them was unable to get a vein and the cuff (like the one for measuring B.P.) would not fit my leg - my quads had not wasted so much at that time also veins collapsed etc. I put lack of success down to poor technique.

As a diagnostic tool my research indicates that blocks are not all that decisive but they can be extremely helpful for some in the relief from pain - the time since onset appears to be a factor in success - apparently, the shorter that time, the better.

From a personal perspective, after 5 years I would still consider neuroablation if I were able to find someone profficient in radiofrequency ablation who would use live filming techniques (x-rays)to address specific neurons.

I am only just starting to consider this as I have tried Spinal column Stimulation (a complete flop).

I have had recent discussions with a doctor (who is not an expert in pain management) that lead me to believe that the longer the condition is established, the less efficacious the technique and the pain can learn new pathways - but I understand that this means more very careful neuroablation.

The technique of ablation appears to matter ; thus chemical and thermal interruption of neural pathways can be a bit general and hence problematic but I understand radio-frequency techniques can be clean and decisive (hopefully). There are other techniques but I am only just starting to head in that direction so my knowledge is a bit shallow.

Best of luck with the procedure.

Best regards Auberon

But you should really research this nerve deal. Learn everything you can, and ask the doctor about pros and cons.

One thing I was told by my doctor is that this procedure does not make an end to the pain. Can possibly cause spread, and can surely grow back over time bring the pain back, and possibly worse pain. Plus can cause other side effects you might not like.

I know the pain is overwhelming at times, but believe me some of the procedures cause more problems then they are worth. Sometimes the best thing we can do is grin and bear it. I know this is not what you want to hear, but it is better than irritating the RSD and making it worse.

Today is the 7th anniversary of me getting RSD, and everytime I do something invasive, it gets worse not better. Maybe that is just me, but I am willing to bet it isnt. In our never ending search for pain relief we would try anything, and so far there really isnt anything promised to work. If there was we all would be lined up to try it.

Hi again,

Obviously none of us can really help you make a decision on such an important issue.

But I agree with Allen, and would just like to add a couple of things.

Firstly, scarring after sympathectomy, neuroablation, neurectomy - call it what you will - has very often led to worse problems; you can see this for yourself just by googling for it. And secondly, remember that if you remove any part of the body's fundamental neural pathways, you rule out taking advantage of any future advances in treatment that may well need those pathways.

By the way, just wanted to let you know that this forum, while usually pretty busy, can be quiet at weekends, specially over public holidays (people have families, kids etc.)...you'll probably get much more feedback on Tuesday, hope you do.

Sounds like you've really been through the mill, so sorry to hear about it all and I do hope they can come up with something a bit less drastic to help soon...

all the best!

hi--I had the radiofrequency nerve ablation performed for right-sided RSD in my arm. My DocPain Management Anesthesiologist permormed it on an out-patient basis. For this procedure, I was under "light sedation" so that I was able to speak. The Doctor used Flouroscopy(live x-ray) to ENSURE that the needle was placed in the EXACT, precise spot. He then made three "discreet lesions" on the peripheral nerve by "burning" tiny little holes with the radio-frequency (sort of like getting micro-waved).

The pain relief was not as "immediate" as I had experienced during the Stellate Nerve Blocks, and my arm did not get that immediate warming effect. However, there WAS a definite improvement in the pain overall. For me, this procedure was done when I was going through a really stressful time, plus the weather was CO:LD COLD, Plus, because of a problem with my house, I was forced to temporarily re-locate, which INCREASED the level of physical activity/use of my arms and hands.

I am CONVINCED that the RF procedure helped decrease my symptoms CONSIDERABLY, as there was NO WAY i could have physically handled what was going on in my life at the time. I estimate that the beneficial effects lasted approximately 8-12 months (for me). During that time, I DID have a flare-up, but an axillary block got it under control .

The winter just following the RF--I was able to "get by" with axillary blocks, for the most part. I did have a Stellate Block in Jan. (almost ONE YEAR after the RF procedure-otherwise, it would have been a whole lot of STGS!!)

Eventually, the effects of the RF wore off, but it was a "gradual" process, more or less. I think the nerves were growing back... I would do it again, because it DECREASED the pain and the number of blocks that I needed over quite a while. (I WILL say, however, after the procedure, my neck was pretty sore for about a week). For ME, it was WORTH IT.

Everyone is so very different though. I have no idea what the prodedure would be like for a leg... If one DOES consider the RF, the expertise of the Doc performing it is CRITICAL. I was VERY LUCKY--my Doc is SUPERB!

I hope this info re my experience helps!

Best Wishes!

Brokenwings

Just wanted to say that I also agree with Alan and Artist. Be very cautious about irritating the nerves. You may make things worse - unfortunately. I know others may have been helped and that is wonderful. However. from experience I can tell you that all invasive procedures have made me worse. They just seem to set off the nervous system and cause more pain in new areas. I had acupuncture which was a disaster. On baby needle in my head caused an immediate severe migrane. Thank goodness for 6 weeks of Trigger point injections. It went away. Then a simple IV in my hand for altrenative medicine treatment of glutithion caused RSD in my hand and arm. Even dental extractions necessitate me having to get TPI in my gums for weeks as the extraction irritates the nerves and causes severe pain.
I could go on and on with ex. but you get the idea.
Of course, that is only me and my experience. Others I am sure have success and I am so happy for them.
Just wanted to caution you as we all are different and think back to any other procedures which caused further pain.
Wishing you the best . I know it is a hard decision as I am now deciding if I want to do the ketamine infuson coma. I am on the waiting list. However, I am really apprehensive about the invasive nature of the treatment. Not sure if I will really go through with it when the time comes.
Best wishes,
Sydney

Another thought along the same lines as artist was saying...

I heard this option suggested back in 1988 and mentioned it to another doctor who said: "OH NO! DON'T DO THAT!" His reasoning was that you were cutting off pathways that not only incorrectly send pain messages, but also correctly warn that you have stepped on something extremely hot, abraded yourself, etc. If you have "no" sensation you can't consciously remove yourself from danger, etc. And your body can't correctly act (however little it still does) to heal wounds and so on.

Yes, you ultimately need to make your own choice. Don't let only one or two poeple sway you too much, but get as much information as you can before this permanant procedure.

Gook luck,

Mike

I recently had to make this same decision. Please read through some of the past posts. I found them very helpful. I spent hour upon hour researching this issue. For myself, I decided against it, mainly because I felt, based on the research that I did, that it could make things worse instead of better. I've already lost the use of a limb from this disorder and do not want to risk making this spread. Please do your homework on this so that you can make the decision that is best for you. Whatever way you go, I hope things go well for you. Hope that this helps.

Question your doctor very carefully about RISKS vs BENEFITS.

Find out how many of these procedures she has performed, and what has been the "long-term" success rate. Also, ask her if that would be her choice if she were in your situation

Good luck to you,

EJ

One of the main reasons I went ahead with the RF was because my Docotor had performed 6 Stellate Blocks. As a result of this, my Doctor was VERY FAMILIAR with my neck anatomy. Since the RF is performed in an essentially identical manner (the only difference being that the needle with the RF is then positioned a bit differently in order to create the "discreet lesions" on the nerve), I had the utmost confidence in my Doctor.

I did not experience ANY of the side effects that "might" occur with this procedure (other than a sore neck). I attribute the success that I experienced to (1). the technical SKILL my Docotor possesses, and just as importantly,(2). my Docotor's familiarity with ME and my neck anatomy. (3). the procedure was performed under flouroscopy, and the Doctor could see EXACTLY where the needle was positioned before zapping the nerve with the RF.

But again, this was just "my experience", and my Doc and I discussed it VERY THOROUGHLY before I made my decision to go ahead with the RF.

Perhaps this info will help.

Sincerely,

Brokenwings