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

I'm definitely repeating myself in part from other posts, but here is why I have an issue with what EA's anesthesiologist stated, the skill of the doc, and the meds used can make a huge difference. Those with suspected SIP can receive Depro Medrol as a part of the cocktail, and this can help. I've experienced blocks done poorly, I've experienced blocks done well technically (with and without Depro Medrol) and the DM made a difference of a day's relief as opposed to 3 weeks relief.

Just because the trend is going away from blocks with certain experts, it can be one of the few options offered to many that don't live near someone offering newer treatments. Insurance will approve blocks. If someone can't go out of pocket in the critical early stage window, this might be one of the few options for them.

I also trust a few of my docs that claim they have had success when they've done blocks early and aggressively. I personally think I'm long past the stage that they'll help lessen my symptoms enough to justify them alone. But, a SGB helped me get through surgery without spread. And I have substantial enough relief to have my doc requesting a tandem of SGB and a Ketamine Infusion.

Those of us that have had RSD for a lengthy period are without question those that have had the worst response to treatment. The RSD experts often see these worst cases. So, the same approach is not always required.

I get in such a hurry sometimes, I post something and hastly walk away, read it later and confuse myself!

I don't think the Pain doctors themselves know exactly why SGB's help CRPS pain. However, it seems to be they are being dictated to by insurance companies, and unless you are Rich as Croceus to be paying for everything yourself, one's medical treatment is somewhat affected by what your medical insurance provider guidelines.

Most Med Ins companies want to see 6 SGB's before they will entertain the thought of a Spinal Cord Stimulator or some other really expensive treatment like a pain pump. It has some positive predictive value that the device would work.

I dont know who told you that but that is not correct at all. Many PM drs will only do 1-3 SGB's. I have seen some paitents however have better controled pain with the SGB's and I personally know a paitent that has had atleast 11 if not more to controle her pain for RSD. And others the blocks dont work at all. Every paitent is diffrent!

As for the insurence, again i dont know where you got that info. My Dr knew i wouldnt do any injections and he offerd right off the bat to go ahead with a SCS and it was not going to be any insurance issue if thats the way i wanted to proceede.

I had quite a number of blocks, followed directly by PT with a therapist who was familiar with RSD. It helped. It is not gone but the help was worth it. Good luck.

My pm did only that one and hasn't brought up another. I am just trying to hit my condition from every angle. He isn't very convinced throwing nerve blocks is the best if my initial results were poor. As long as it is confined to my hand area I will just stick to what I have been doing. If it gets worse in the future, I will act accordingly. Thank you all.

I agree that every patient is different. I was informed by the pain mgmt clinic that I went to before that they will do 5-6 Stellate Ganglion Blocks before then doing the SCS, and that insurance companies they deal with usually prefer it this way. Note the term, Usually.

If you want to know the name of my Pain Management Clinic and the Doctor who "told me that", please feel free to PM me. They have 8+ M.D./D.O.'s on staff, 4 different offices, their own SurgiCenter, and they are the biggest Pain Clinic in Northern California. That should be a hint.

You sounded very hostile in your posting, and I was just repeating my understanding from what my 3 years of being a Pain Managed Patient has been. I apologize if I offended you in any way, so sorry about that!