| Reflex Sympathetic Dystrophy (RSD) is a chronic | | | | what kind of medication to use. It is common for |
| neurological syndrome that is also known as Complex | | | | doctors to use multiple medications to control pain. |
| Regional Pain Syndrome (CRPS). RSD/CPRS occurs | | | | Oftentimes patients are given a sequence of |
| when the nervous system functions abnormally after | | | | medications in order to determine what works best. |
| an injury. Symptoms involve severe burning pain, | | | | The following factors are taken into consideration |
| pathological changes in the bone and skin, excessive | | | | while determining what kind of medications to use: |
| sweating, tissue swelling and extreme sensitivity to | | | | 1. Constant pain |
| touch. | | | | 2. Inflammatory pain |
| RSD/CRPS can be diagnosed when an injury, no | | | | 3. Muscle cramps |
| matter how slight, fails to heal normally. There is no | | | | 4. Spontaneous pain |
| laboratory test that can diagnose RSD/CPRS, but a | | | | 5. Pain that interferes with sleep |
| doctor can make the diagnosis based on past medical | | | | 6. Sympathetically maintained pain (SMP) |
| history, and the results of a physical examination. | | | | 7. Pain due to recent injury |
| Usually when a patient has a history of trauma to an | | | | 2. Physical Therapy |
| affected area, and an injury that involves an unusual | | | | Physical therapy, hydrotherapy, massage therapy and |
| amount of pain, doctors can diagnose RSD/CRPS if | | | | even pool therapy can help relieve pain for CRPS |
| the injury is accompanied by one of the following: | | | | patients. Pain can also be reduced by techniques such |
| 1. Swelling | | | | as applying pressure. Physical therapists can also |
| 2. Movement disorders | | | | educate patients about different ways that they can |
| 3. Abnormal function of the sympathetic nervous | | | | use the injured part of their body. |
| system | | | | 3. Sympathetic nerve blocks |
| 4. Changes in tissue growth. | | | | Sympathetic nerve blocks can reduce pain and |
| There are two types of complex regional pain. Type | | | | provide important diagnostic information. Chronic pain |
| I is known as RSD, and Type II is known as | | | | is often caused by sympathetic nerves that regulate |
| Causalgia. | | | | blood flow, sweating and glandular function. When the |
| Type I involves a nerve injury that is not immediately | | | | nerves are blocked, pain is sometimes relieved. For |
| identifiable. It starts with an immobilizing event that | | | | example, pain in the legs and feet can be relieved |
| involves a disproportionate amount of pain. The | | | | when the lumbar sympathetic nerves on the spine in |
| event is followed by edema and changes in the skin | | | | the lower back are blocked. Furthermore, pain in the |
| coloration or skin temperatures, which is caused by | | | | face, arms and hands can be relieved when nerves |
| skin blood flow. The injured area can also be | | | | along the spine in the lower neck are blocked. |
| affected by abnormal sudo-motor activity. | | | | 4. Surgical Sympathectomy |
| Type II involves a distinct major nerve injury that | | | | A significant reduction in pain from a sympathetic |
| causes continuing pain long after the event of an | | | | block occurs when a patient has Sympathetically |
| injury. Like Type I, this is also followed by abnormal | | | | Maintained Pain (SMP). On the other hand, when |
| suto-motor activity at the point of injury, as well as | | | | sympathetic blocks do not relieve pain, a patient has |
| edema and changes in skin blood flow. | | | | Sympathetically Independent Pain (SIP). Surgical |
| Treatment | | | | Sympathectomy can be performed on patients with |
| Currently, there is no cure for RSD/CPRS. However, | | | | SMP, to insert a permanent nerve block. |
| there are methods of treatment that can reduce | | | | Sympathectomy is an invasive surgery, so it is usually |
| pain and prevent the problem from getting worse. | | | | an option of last resort. Before a having a |
| 1. Medications | | | | symapthectomy, patients should consult with their |
| Doctors weigh a number of factors while deciding | | | | doctors about the possible complications. |