All types of nerve blocks may need to be repeated even if they are successful and all successful nerve blocks should be followed by intense physical therapy. Some physicians will prescribe the physical therapy for 6 weeks prior to doing any nerve blocks. Epidural blocks are used if the physician wants to block the sympathetic nervous system of both legs either because of the presence of crossover fibers or because RSD exists in both lower extremities. The medication is placed in the epidural space so that it will affect all nerves and not just sympathetic nerves. Usually the patient will have a period of numbness in the lower extremities after an epidural block.
Axillary blocks are another type of block for the upper extremity.
In this type of block, the medication is placed in the armpit and will cause numbing and loss of controlled movement for a period of time. Bier blocks are used when the RSD is limited to the lower part of any extremity. Then a tourniquet is applied to prevent the flow of blood and medication is injected directly into the arteries. After about 20 minutes, the tourniquet is removed and the blood returns to the limb as it pushes the medication throughout the body. Continuous blocks are used when a series of blocks isn t successful or the symptoms return quickly.