REFLEX SYMPATHETIC DYSTROPHY SYNDROME

[Pages:12]R.S.D.S

REFLEX 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

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.

DIAGNOSIS

INSIDE LOOK

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 XRay, 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 AREAS

STAGES OF R.S.D

STAGE 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.

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. XRays 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:

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!

STAGES OF R.S.D

DEATH

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