Understanding what a symapthectomy is will help you to understand the progression of reflex sympathetic dystropy and treatment options available to you. At the most basic level, sometimes the combination of pain management medication and nerve block or electrotherapy prove useful and a longer-term solution is sought. This longer-term solution can come in the form of a surgical intervention, or sympathectomy. This surgery involves the removal of sympathetic nerve fiber from the affected area and is called a sympathectomy because of the removal of this problematic nerve tissue. If there is a significant decrease in pain following a nerve block, the chronic pain being felt can be categorized as sympathetically maintained pain (SMP). If there is not a significant decrease in pain, it is likely sympathetically independent pain (SIP).
Only patients with SMP should be considered for a sympathectomy. The pain relief from a sympathectomy will be consistent with the relief achieved from a nerve block. As such, it is critically important to accurately gauge the level of pain prior to a nerve block and compare it to the reduction in pain following the nerve block. A sympathectomy is a serious surgical procedure with potential complications and should be pursued only if the relief achieved by a nerve block is substantive relative to the ongoing level of chronic pain, given the risk.
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