Originally Posted by Neurochic

I think Lit Love is on the money with the comments that all of the experimentation and unpleasant stuff is life with CRPS. That is simply the reality of living with this condition in anything other than a mild form for any length of time. It's also true that at different periods in the course of the condition, different management strategies will be needed.

From my research, the current view amongst the leading CRPS researchers and clinicians in relation to sympathetic blocks is exactly as Emily's specialist described it to her. The view seems to be very much turning away from doing endless repeated blocks to doing only 1-3 and largely using it as a diagnostic tool. It's not used as a diagnostic tool to determine how the pain is mediated though, it is used as a diagnostic tool to determine whether CRPS is present or not. The general body of opinion seems to be that if a patient receives any pain or other symptom relief (other than for the period of a few hours whilst the local anaesthetic in the block is working) then this is a 'bonus' rather than an expected outcome.

I wouldn't be surprised to see treatment guidance in the future placing far less emphasis on carrying out multiple sympathetic blocks. I suspect that they will increasingly be seen to have minimal value as a CRPS 'treatment'. Of course there will always be individuals for whom multiple blocks will be a helpful part of longer term treatment but for the typical majority, I think it will be different.

In much the same way, it has become much clearer that as more work has been done using SCS with larger numbers of patients, there are typical CRPS patients who are likely to get benefit and patients who won't. The patients for whom they are generally most effective are those where their symptoms are confined to one limb. Patients with pain in multiple limbs are much less suitable for SCS implantation because they typically have much poorer outcomes. As increased information becomes available, it at least allows everyone to make more informed choices.

Originally Posted by LIT LOVE

Dubious, I think you misunderstood my post. I even thanked you for the post the other day. I was really responding to the OP thinking your case was extraordinary in what you've had to deal with. And well, of course it has been, but it's typical for an RSD patient.

Originally Posted by Neurochic

Dubious

You have very much misunderstood what I was saying. I didn't say that SGBs would run their course and be 'shelved'. I was very careful in the language I used exactly so that I didn't say that. I was, in fact, making the point that there will always be people for whom sympathetic blocks are an effective therapeutic option. I was also careful to recognise that people are all different as are their symptom patterns. I want to make sure that what I actually said is correctly represented.

You clearly have a very strong view about the medical profession and the current vogue for evidence based medicine so it is not something I will comment on. I would only comment that taking internet based medical advice from other people with a diagnosis that purports to be the same as ones' own is certainly not risk free, information offered in good faith can be completely incorrect nor is it necessarily going to give any better an outcome. Many of us share professional knowledge of the healthcare industries and/or medico-legal fields but although we don't share your views, ours are still just as valid.

Originally Posted by Dubious

And Litlove, there is nothing you can say that changes my amazingly positive experiences (as much as I hate the SGB process, it worked for me).
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Originally Posted by LIT LOVE

Dubious, I thought we were in agreement, the above just confused me.