Nerve Blocks?!?!? Please help!!!!?!


Question: Nerve Blocks?!?!? Please help!!!!?
Today I found out my daughter has RSD (Reflex Sympathetic Dystrophy). She is 12 years old She is going to get nerve blocks in her hand because of the RSD pain. My daughter is also very afraid of needles! Also she's been having lots of twitching and spazing in her hand. It's causing her lots of pain! Her appointment is on April 8th.

So I'm wondering....

Is the spazing and twitching normal?

What will they do?

Will they put her to sleep?

Will they put anything on her arm after they block the nerves? (like a cast, splint, sling?)

Will her hand be the same ever again after they are done?


Thanks!

Answers:

Hello again.

I did answer your earlier questions last night, but now that I'm more awake I'll try to give you a more thorough answer, and hopefully be able to set your mind at rest a little. I'm 26 and I watch what my mum & dad go through with me having CRPS/RSD, and my heart goes out to you having to watch your wee girl going through this sort of pain - as well as to her for going through it. I'm so glad that her appointment for the nerve block is very soon.

The spasms and twitching are quite common symptoms. If they continue to bother her and are causing her a lot of pain, it might be worth asking her doctor about a drug called 'Baclofen'. This is a muscle relaxant - I think it was originally used for cerebral palsy and MS patients, but it's quite commonly used to manage spasms in CRPS patients too.

What will they do - I'm assuming as I said to you earlier that she's having a 'stellate ganglion block' or 'sympathetic nerve block'? In CRPS, it's thought that some of the symptoms and signs (some of the pain, plus things like swelling, colour/temperature change) are due to abnormal activity in the sympathetic nervous system. By blocking the sympathetic nerves to her hand, they are trying to reverse these changes. She will probably be lying down, and the doctor will use fluoroscopy (basically a 'real time' x-ray image) to locate the nerve. She'll probably be sedated, and they'll also use local anaesthetic so that the block injection itself won't be painful. If it's successful, she'll feel her hand and arm get warm, and hopefully the pain will be decreased. Most people need multiple blocks, but this will depend on how well hers works and how long it lasts for.

They won't put anything on her arm. The block doesn't affect her muscles, or (in most cases) even her sensory nerves - her sense of touch.

I truly hope that her hand will return to normal, and I think that with aggressive therapy she should stand a good chance of this happening.

I think I asked in my earlier answer whether you had a good pain management team for her? The best CRPS therapy is multidisciplinary - pain management specialist (a doctor who can deal with medications and procedures), a physiotherapist (physical therapy is crucial!), and sometimes others like a psychologist can also be of benefit - not because any of this is in her head, but because there are pain psychs who can help to teach her different methods to manage her pain - self hypnosis, body awareness, etc.

Best of luck - and again please feel free to contact me if I can be of any help whatsoever.

I have had CRPS since I was 14




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