 Lumbar sympathetic block will be performed twice on each patient: once as in the standard of practice with 10 cc 0.5 Bupivicaine and once with 75 units of Botox in 10cc of 0.5 Bupivicaine. These will be done in random order and the investigator and the patient will be blinded to which medicine they received. Two weeks after their pain has returned to 75 of their baseline they will receive the second of the blocks. 