IV Lidocaine Infusion for RSD/CRPS - Effectiveness?

Good afternoon.  Has anyone recently had an infusion of Lidocaine through an IV for pain related to CRPS/RSD?

Last week my new pain service suggested that I have this done to see if I get any relief.  I am several years in with chronic pain with only a recent diagnosis of CRPS Type 2 (Ulnar Nerve issues).  In doing some reading about this treatment it appears to help in acute cases and not so much in cases that are years in.  I have had ulnar nerve pain since 1994.  Two surgeries, most recent in 2009 which seems to be where and when the pain increased the most.

My standard pain service referred me out to an "invasive" Pain Management Center for an evaluation.  After a review of my history, many drugs, many stellate blocks, cortizone, 2 surgeries, etc....the IV Infusion of Lidocaine was suggested.  They told me that this is the simplest way to determine if lidocaine type drugs would be effective.  If not, they suggested a Spinal Cord Stimulator - brought out all of the literature, etc and sent me home to think about it, to review with my family.  I think this through me a little bit...I expected many other ideas on treatment options.  They offered 2, with standard protocol being the IV Infusion of Lidocaine, then the stimulator surgery.

As you are all to aware - when you are in pain, it is hard to focus on the details.  My sister goes with me and takes very good notes and asks the questions I cannot remember to ask.  Neither one of us had any details about the longevity of the pain relief from the lidocaine infusion and whether or not this could be a regular treatment to have to go through.  In most of the articles I have found I do not see details about what to expect if it does help.  1 hour, 2 hours of relief, or days or months of relief?  Do you need 2 of them or 50 of them?

If you have any details to share it would be very helpful.  Also, I researched the facility and their phiosophy on pain management - they seem to focus quite a bit on the stimulator implant surgery.....is it me, or does it seem that whatever the group focuses on that is what they offer for treatment?  Is there a pain service out there that thinks out of the box?

I appreciate your review of my question -

i found one study of 49 patients and results were quite good. reduction in pain after treatment lasted an average of 3 months.....heres link

Pete, sorry I had to edit out the link,please look at rule number 5, thanks.
pal pete

Post Edited By Moderator (straydog) : 1/28/2013 9:58:11 PM (GMT-7)

Hi JL,

There seem to be almost as many different opinions out there on IV lidocaine use as there are different studies - ranging from 'highly effective' through to 'absolutely no indication for its use'. It's important to remember with CRPS that although we fit within the broader syndrome for diagnostic purposes, almost everyone presents in a slightly different way -- and almost everyone responds differently to treatment - e.g. one person may achieve months or years of remission with a sympathetic nerve block, while another person may experience worsening pain and even spread to other sites.

It sounds like you've been through the more routine procedures - the blocks, medications... has physio (especially with focus on things like mirror box therapy) been part of your treatment?

Stimulators - for what it's worth, I'm coming up seven years with mine. I've had a lot of problems with it- migrating leads, shorting leads, slow healing incisions, keloids - and i use both oral meds and a pump, but I wouldn't be without it. It's certainly not a first choice type option though, you should definitely explore as many others as possible first - maybe there is another med option? Maybe someone can offer ketamine?

Hi Cheryl and welcome to HW. This thread is a few months old and we like for you to start an intro post of your own so every one can welcome you.

I also removed your personal links as they can be accessed via the forum email options.