R.S.D.SREFLEX SYMPATHETIC DYSTROPHY SYNDROME

Brittany Marron

Dustie Montes

WHAT IS R.S.D?

Reflex Sympathetic Dystrophy, is a chronic neurological syndrome characterized by:

severe burning pain

pathological changes in bone and skin

excessive sweating

tissue swelling

extreme sensitivity to touch

WHO CAN GET R.S.D?

Who can get CRPS/RSD?

Anybody! Anyone can get CRPS/RSD at any

age, but studies show that it is more common

in people between the ages of 25 and 55, and

is more frequently seen in women than in men.

It used to be considered rare in children, but

there has been a recent increase in the number

of cases among adolescents and young adults

DIAGNOSIS

DIAGNOSIS INSIDE LOOK

A physician must make a clinical diagnosis of

CRPS/RSD using a patient history, a thorough

examination, and the results of numerous

tests. There is no single test for CRPS/RSD.

Early diagnosis and treatment with pain control,

physical therapy, and counseling offer the

highest probability of remission from CRPS/RSD.

STAGES OF R.S.D

STAGE ONE :

Stage one is called the acute stage

and can last one to three months

from onset.

Some characteristics are warmth,

coolness, burning pain, edema,

increased sensitivity to touch,

increased pain, accelerated hair/nail

growth, tenderness or stiffness in the

joint, spasms, limited mobility, some

bony changes may be visible on X-

Ray, abnormal amount of pain for the

injury. In this stage there is

decreased sympathetic activity. For

the patient, she, typically a she, may

feel as if their limb is on fire and is

amazed when it actually feels cool to

the touch (this is due to the lack of

blood flow to the extremities).

STAGES OF R.S.D

THERMO GRAMS OF EFFECTED AREASSTAGE TWO

Stage two is called the Dystrophic Stage and can last three

months to one year.

Pain is constant, as in stage one, and throbbing, burning,

aching, crushing in nature and is exacerbated by any stimuli.

The affected limb may still be edematous, cool, cyanotic

(discolored), or mottled (different shades). Nails are brittle and

ridged. Pain and stiffness persists. Muscle wasting may begin.

Patient usually starts experiencing short-term memory

problems , as well as increased pain from noises and/or

vibrations and other changes in the limbic system. These may

include, but are not limited to; the inability to concentrate,

inability to find the right word when speaking, depression, and

irritability. X-Rays may reveal signs of osteoporosis. Patients

may start to repeat themselves. In this stage there is also signs

of increased sympathetic activity.

Some Doctors will try and use tools such as X-Rays, Bone

Scans, thermo grams and others during Stage 2 and Stage 3 to

confirm a diagnosis of CRPS/RSDS. Understand that while

these tests MAY show the presence of CRPS/RSDS, they are

rarely conclusive and they should not be used as the sole

determining factor in whether a patient does or does not have

CRPS/RSDS. The only positive way of diagnosing CRPS/RSDS is

a physical exam by a Doctor knowledgeable in CRPS/RSDS.

These other tests should only be used as one of many tools to

aid in that diagnosis. They are also useful in tracking the

progress of the disease over the course of the time.

STAGES OF R.S.D.

STAGE THREE :

Stage three is called the atrophic stage and can last an unlimited amount of time. Pain as usual is typically constant but can increase or decrease, depending on the person, and the CRPS/RSDS may spread to other parts of the body. At this stage irreversible tissue damage may occur. Skin becomes cool, thin and shiny.

Contraction of the extremity may occur as well as atrophy of the limb (decreased joint movement). Skin atrophies (wasting away) and loss of movement or mobility may also occur. X-Rays may show marked demineralization and increased osteoporosis.

At this stage many CRPS/RSDS patients are not likely to be effectively treated with blocks as the percentage of SIP (Sympathetically Independent Pain) is now much greater than the percentage of SMP (Sympathetically Mediated Pain), meaning the majority of the pain signals are now originating in the brain and not at the original RSD site where a local block would help.

Pumps and Spinal Column Stimulators are usually discussed at this stage but there are other treatments available and more are coming all the time. Surgical treatments such as these should only be considered as a last resort.

STAGES OF R.S.D

STAGE FOUR: DEATH

Most patients will never advance to Stage 4.

In this Fourth Stage CRPS/RSDS is resistant to many forms of treatment.

Also in this stage there is an involvement of the internal organs.

Please do not allow any Doctor to amputate the affected limb unless it is a medical necessity due to gangrene or the like. While it is infrequent, amputations in an effort to eliminate the CRPS/RSDS pain are still being done. This is not only barbaric it is ineffective. It not only does not work but it also in most cases will exacerbate the CRPS/RSDS and increase the spread rate.

Always ask to speak to a Doctor's other patients before undergoing any type of implant or surgical procedure. Educate yourself on the internet. Talk to other patients. In the end, YOU are most responsible for what happens to your body. It is the only one you get so treat it with the utmost care. You deserve first class care always!

TREATMENT:

Treatment: “Treatments may include a wide variety of

medications,

nerve blocks, physical therapy, and

psychological support for people with

CRPS/RSD as well as for friends and family.

Occasionally, surgical procedures are needed to

control pain and abnormal nervous system

responses. Treatment is individualized. Each

patient should have a treatment plan that

includes pain control, psychological support,

and physical and occupational therapy.”

Is there a cure? “No, but there is hope! Advances in research on

pain and CRPS/RSD have helped find some new

and effective treatments. More money and

more research is needed to achieve the goals of

understanding the causes of CRPS/RSD, finding

effective treatments for those living with

CRPS/RSD, and preventing the development of

CRPS/RSD after injury and tissue damage.

Reflex Sympathetic Dystrophy Syndrome

Association of America (RSDSA) promotes public

and professional awareness of CRPS/RSD. It

educates those afflicted with the syndrome,

their families, friends, insurance companies,

healthcare providers, and others. RSDSA

encourages those with CRPS/RSD to offer emotional

support to others through affiliated support

groups. RSDSA is committed to raising

funds for research to find the causes and cures

for CRPS/RSD.”

DEALING WITH THE PAIN

ANTISPASMODICS / MUSCLE RELAXANTS –MUSCLE SPASMS ARE VERY COMMON WITH RSD, TYPICALLY ROLLING IN NATURE. THE MEDICATIONS USED TO TREAT THIS CAN INCLUDE BACLOFEN, CLONAZEPAM, FLEXERIL, SOMA, AND ZANAFLEX. SOMETIMES A DOCTOR MAY PRESCRIBE A BENZODIAZEPINE FOR THIS. THESE CAN INCLUDE KLONOPIN, VALIUM, AND XANAX. ANTISPASMODICS SUCH AS NEURONTIN CAN BE PRESCRIBED FOR SPASMS BUT THIS IS NOT CONSIDERED A PAIN-RELIEVING DRUG ANYMORE, NOT SINCE THE LATEST REPORTS WERE RELEASED (see other articles on this website for more information).

NSAIDS – USED TO TREAT SWELLING AND INFLAMMATION. THESE CAN INCLUDE CELEBREX AND FELDENE. THEY FORMERLY INCLUDED VIOXX AND BEXTRA BUT THEY HAVE BEEN TAKEN OFF OF THE MARKET. ACCORDING TO DOCTOR TIM SAMS, “MOST RESEARCH HAS DEMONSTRATED THE EFFICACY OF THE COX-2 INHIBITORS, (CELEBREX/FELDENE) BUT HAS CLEARLY NOT FOUND THEM TO BE BETTER PAIN RELIEVERS THAN THE OLDER OR EVEN NONPRESCRIPTION NSAIDS”.

NMDA RECEPTOR BLOCKERS - THIS WOULD INCLUDE THE DRUG KETAMINE. I WOULD REFER YOU TO THE FOLLOWING SECTION FOR INFORMATION, ARTICLES, AND STUDIES REGARDING THE USE OF KETAMINE IN THE TREATMENT OF RSD / CRPS;

DRUG THERAPIES – DRUG THERAPIES ARE NOT A CURE BUT THEY CAN OPTIMIZE PAIN CONTROL AND

PROVIDE THE RELIEF NECESSARY TO REGAIN FUNCTION AND ALLOW THE

PATIENT TO PARTICIPATE IN PHYSICAL THERAPY.

FOR CHRONIC PAIN PATIENTS, DRUG THERAPIES ALLOW PATIENTS TO REGAIN A

BALANCE IN THEIR LIVES AND RESUME MANY ACTIVITIES THEY HAD PREVIOUSLY

STOPPED. HERE WE WILL SIMPLY GIVE THE BASIC MEDICATION TYPES, AN

EXAMPLE, AND WHAT THEY ARE FOR

NARCOTICS – USED TO MASK PAIN BY BLOCKING PAIN RECEPTORS FROM

SENDING PAIN MESSAGES TO THE BRAIN. NARCOTICS ARE ALSO KNOWN AS

OPIOIDS. THESE ARE BROKEN DOWN INTO THREE TYPES; CODEINE-BASED

MEDICATIONS, THE OXYCODONE BRANCH (OXYCONTIN CR and IR, PERCOCET,

PERCODAN, for example), AND THE HYDROCODONE BRANCH OF OPIODS (MS

CONTIN, VICODIN, LORTAB, LORCET, METHADONE, AND KADIAN, for example).

ANTIDEPRESSANTS – ORIGINALLY ONLY USED TO TREAT DEPRESSION, STUDIES

HAVE SHOWN THAT THESE MEDICATIONS, BOTH THE NEWER ANTIDEPRESSANTS

AND THE OLDER TRICYCLIC VERSIONS, CAN ALLEVIATE PAIN IN CERTAIN

SITUATIONS. FURTHERMORE, THEY MAY HAVE THE ADDED BENEFITS OF NOT

ONLY HELPING THE PATIENT SLEEP BETTER AT NIGHT BUT ALSO REDUCING

SOME OF THE HEADACHES ASSOCIATED WITH RSD/CRPS; ALTHOUGH SOME

HAVE A TENDENCY TO CAUSE WEIGHT GAIN AND DROWSINESS. PAXIL, ZOLOFT,

ELAVIL, PAMELOR, AND TRAZADONE ARE GOOD EXAMPLES.

TRANSDERMAL MEDICATIONS – PAIN PATCHES, LIDOCAINE AND

DURAGESIC/FENTANYL. MOST IMPORTANT WITH THESE ARE THEIR PLACEMENT.

CHECK WITH YOUR PHYSICIAN, BUT TYPICALLY THEY ARE NOT PLACED DIRECTLY

OVER THE RSD-AFFECTED AREA.

A

AWARENESS AND FUNDRAISING GO HAND IN HAND

DONATION RECOGNITION PAGE

TRIUMPH OVER PAIN 5K 10K FUNDRAISER FOR CRPS

National RSD Awareness Pins and National RSD Bracelets

MOTORCYCLE RUN FOR AMERICAN RSDHOPE NETS $1600

NATIONAL PAIN CARE POLICY ACT - PASSED THE HOUSE!

TEAM RSD - CORBIN RACING/ NOLAN DEAN RACING

LEGISLATION FOR RSD AWARENESS

AMERICAN RSDHOPE SPEAKS TO MAINE LEGISLATURE

SON RUNS TO RAISE RSD AWARENESS FOR MOM

CURRENT OR PENDING CRPS LEGISLATION

WALKS FOR RSD/CRPS AWARENESS

NATIONAL RSD AWARENESS RIBBON FOR YOUR WEBSITE!

RACING FOR AWARENESS - RIBBONS ON RACE CARS!

RSD MENTORS - NEW TO RSD? NEED A MENTOR? WANT TO BE A MENTOR?

RACING FOR AWARENESS!

HOW YOU CAN YOU, A LOVED ONE, HELP?

WANT TO HOLD A WALK-A-THON FOR RSDHOPE

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SOURCE PAGE:

Rsds.org

Rsdhope.org

Lispy.facebook.com

Rsdfoundation.org

Thermgramcenter.com

Mmice.nl

Suimed.edu

Wellsphere.com

Uspharmasists.org

Ripleygrad2000.com

10keveryday.com

Kristalynn-crps.blogspot.com

http://www.rsds.org/http://www.rsdhope.org/http://www.lispy.facebook.com/http://www.rsdfoundation.org/http://www.thermgramcenter.com/http://www.mmice.nl.com/http://www.suimed.edu.com/http://www.wellsphere.com/http://www.uspharmasists.org/http://www.riplygrad2000.com/http://www.10keveryday.com/http://www.kristalynn-crps.blogspot.com/http://www.kristalynn-crps.blogspot.com/http://www.kristalynn-crps.blogspot.com/