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[Complex Regional Pain Syndrome (CRPS)]

Dillion February 23rd, 2016

What is Reflex Sympathetic Dystrophy (RSD) Syndrome?

RSD is an older term used to describe one form of Complex Regional Pain Syndrome (CRPS). Both RSD and CRPS are chronic conditions characterized by severe burning pain, most often affecting one of the extremities (arms, legs, hands, or feet). There are often pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch, known as allodynia.

RSD is sometimes called Type I CRPS, which is triggered by tissue injury where there is no underlying nerve injury, while Type II CRPS refers to cases where a high-velocity impact (such as a bullet wound) occurred at the site and is clearly associated with nerve injury. Type II used to be called "causalgia" and was first documented over 100 years ago by doctors concerned about the pain that Civil War veterans suffered even after their wounds had healed. RSD is unusual in that it affects the nerves, skin, muscles, blood vessels and bones at the same time.

What are symptoms of RSD/CRPS?

The key symptom is, chronic, intense pain that is out of proportion to the severity of the injury (if an injury occurred) and which gets worse over time rather than better. It most often affects the arms, legs, hands or feet and is accompanied by:

burning pain

increased skin sensitivity to touch

changes in skin temperature: warmer or cooler compared to the opposite extremity

changes in skin color: often blotchy, purple, pale or red

changes in skin texture: shiny and thin, sometimes excessively sweaty

changes in nail and hair growth patterns

swelling and stiffness in affected joint

motor disability, with decreased ability to move affected body part

What causes RSD?

The cause of RSD is not known. The condition is thought to be a malfunctioning of the sympathetic nervous system, but some researchers are questioning this. Since RSD most often follows trauma to the extremities, some conditions that can trigger RSD are sprains, fractures, surgery, damage to blood vessels or nerves and certain brain injuries.

How is RSD diagnosed?

There is no single laboratory test to diagnose RSD. Sometimes imaging studies (x-rays, MRI) or nerve conduction tests are useful, Diagnosis can be made by the healthcare provider when certain conditions are met, including the absence of any other diagnosis that better explains the signs and symptoms. Early diagnosis is thought to be important in preventing progression of the syndrome.

How is RSD treated?

Physical therapy is a primary component of treatment. There also are several types of medications that can be used. Surgical procedures may also help reduce symptoms. Treatment plans are individualized and often incorporate several of these measures.

Is there a cure?

There's no cure at this time, but research continues. Advances have resulted in some new and effective treatments. Some patients may experience a remission of symptoms.

For more information on RSD/CRPS contact the following organizations:

National Institute of Neurological Disorders & Stroke

National Institute of Health

http://www.ninds.nih.gov

Reflex Sympathetic Dystrophy Syndrome Assn.

Tel: 877-662-7737

http://www.rsds.org

American RSDHope Group

Tel: 207-583-4589

http://www.rsdhope.org/

American Chronic Pain Assn. (ACPA)

Tel: 800-533-3231

http://www.theacpa.org

Special Thanks to the NYC Department of Health for this information!
4
Dillion OP February 23rd, 2016

Tagging forum friends and supporters to also tag others that may be interested in learning more, or share experiences

@Nazeera @Elle22 @Rycochet @faithlove1111

@AffyAvo @JoyIntoDarkness

faithlove1111 February 24th, 2016

Thank you Dillion. I read an interesting article about this. This is the link . http://hubpages.com/health/Mystery-Diagnosis-RSD-Reflex-Sympathetic-Dystrophy

Needtovent March 16th, 2016

As a sufferer this was my personal favorite description of the disease because of how true it is :

"I was asked recently at my Doctor's office by a visiting intern, "What does CRPS feel like?" This is a question I get asked quite often by the media as well. They want to know what the typical CRPS patient feels when they experience this pain. Every patient is asked this question, the detail of your answer depends on who is asking and the extent of interest they have in the answer. If they are asking what is CRPS pain like in comparison to other diseases you give the McGILL Pain Index answer, "CRPS pain is ranked as the most painful form of chronic pain that exists today and is ranked on the McGill Pain Index at a whopping 42!" (look for "causalgia" on the chart). If they are asking as a friend and you don't want to scare them away you simply say "It is the most pain I have ever experienced, it hurts constantly."

After all, many patients have already lost a great many friends because of the disease and they don't want to lose more. If they are a loved one you try and protect them. You don't want them to know how bad it is. You don't ever want them to truly understand how much you suffer because you know how much they would then suffer as well. Many times your answer is simply, "I am fine. It is nothing I can't handle." Once in a great while you may let them know how truly horrible it is, after all, they see it in your eyes. But most of the time you try and shield them from the depth of your pain. If you have only had it for a year or two you aren't as skilled at hiding your pain, or controlling it, as someone who has had it for ten or more.

I think long-term chronic pain patients get so good at masking their pain, our pain, that when we have to reveal it, when we come upon circumstances where medical professionals need to see the actual level of pain we are in, it is difficult for us to convey the depth of the pain, to truly let down our guard, those walls we have built up, for fear of not being able to put them back up again. It can actually be difficult to completely let down those protective barriers to reveal exactly how much pain we are in and many times our Doctors, especially new ones, don't realize just how bad our pain actually is.

So, having said that, what does CRPS pain actually feel like? Let me share with you what I shared with my Doctor recently and maybe it will help you understand our pain a little better. CRPS pain can be anywhere in the body where there are nerves. Most commonly in the four extremities but some people have it in other areas such as eyes, ears, back, face, etc. What does it feel like? Well, if you had it in your hand, imagine your hand was doused in gasoline, lit on fire, and then kept that way 24 hours a day, 7 days a week, and you knew it was never going to be put out. Now imagine it both hands, arms, legs, feet, eyes, ears; well, you get the picture. I sometimes sit there and am amazed that no one else can see the flames shooting off of my body.

The second component to CRPS is what is called Allodynia. Allodynia is an extreme sensitivity to touch, sound, and/or vibration. Imagine that same hand now has the skin all burned off and is completely raw. Next, rub some salt on top of it and then rub some sandpaper on top of that! THAT is allodynia! Picture getting pretty vivid? Now, because of the allodynia, any normal touch will cause pain; your clothing, the gentle touch of a loved one, a sheet, rain, shower, razor, hairbrush, shoe, someone brushing by you in a crowded hallway, etc. In addition, sounds, especially loud or deep sounds and vibrations, will also cause pain; a school bell, thunder, loud music, crowds, singing, yelling, sirens, traffic, kids screaming, loud wind, even the sound in a typical movie theatre. This is what allodynia is all about. Imagine going through your daily life where everything that you touch, or that touches you, where most every noise around you from a passing car or plane to children playing, causes you pain, this, in addition to the enormous pain you are already experiencing from the CRPS itself. Imagine living with that pain and allodynia 24 hours a day, every day, for months, years, and longer."

1 reply
faithlove1111 March 16th, 2016

@Needtovent , Severe pain inpedes and sometimes oppreses every aspect of one's life. It is a cycle which always seems to cause so much of constant ups and downs. Good pain management knowledge and habits help to withstand the downs to certain degree. The most important thing is :Both the person and his/her loved ones To accept that the pain is real and it's really painful, not imagined or exaggerated. .

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