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Treatments For RSD/CRPS

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     This section is to provide you with the knowladge about treatments for RSD. Please remember to disscuse treatment with your doctor. This section is only to inform you about treatments for RSD
 

Because research is so recent, there is not a lot in the way of treatment. Most treatments for RSD revolve around pain-control. While this is all some patients need, a very good percentage of RSD patients have other symptoms that need to be taken care of (muscle weakness, dystonia, tremors, etc). Every RSD patient is so different. One thing might work wonders for one patient and it may make the next patient ill. With more research we hope that there will be more treatment options for RSD.

One of the most common treatments for RSD are Nerve Blocks.  Nerve Blocks are an injection of local anesthetic to block the passage of impulses along nerves. Below are different types of nerve blocks:

  • Sympathetic Nerve Block: A sympathetic nerve block is one that is performed to determine if there is damage to the sympathetic nerve chain. This is a network of nerves extending the length of the spine. These nerves control some of the involuntary functions of the body, such as opening and narrowing blood vessels.
  • Stellate Ganglion Block: This is a type of sympathetic nerve block performed to determine if there is damage to the sympathetic nerve chain supplying the head, neck, chest or arms and if it is the source of pain in those areas. Although used mainly as a diagnostic block, the stellate ganglion block may provide pain relief in excess of the duration of the anesthetic.
  • Bier Blocks: This is another technique used to carry out a sympathetic block involving the injection of sympathetic blocking agents into an extremity and limiting spread of the agent to the entire body by applying a tourniquet to the extremity.  This method requires placing an IV in the painful extremity and may be technically extremely difficult due to severe swelling (edema) of the extremity
  • Lumbar Sympathetic Block::Lumbar Sympathetic blocks are just like Stellate ganglion blocks. the only difference is that the block is performed for your lower extrmities

http://my.clevelandclinic.org/services/nerve_block/hic_nerve_blocks.aspx

Here are other treatments for managing RSD pain:

Tunnled Epidural Catheter (TEC) : A TEC is a very fine plastic catheter (tube) that is placed through the skin into the epidural space in your spine. This temporary catheter is left in place for a defined period of time; normally less than (2)two weeks. The catheter allows access to the epidural space to inject medication such as local anesthetics and/or narcotics for relief of pain. Temporary epidural catheters are used for tempory treatment of painful conditions that require pain control for intensive physical therapy.

Spinal Cord Stimulator: It is a therapy that uses electrical impulses to block pain from being perceived in the brain. Instead of pain, the patient feels a more pleasant tingling sensation. The other thing about it is you are able to control if you want / need more relief, less relief and you can turn it off and on simply with a remote.

ANS Spinalcord Stimulator Website: http://www.ansmedical.com/patients/WhatToExpectWithASCS/WhatToExpectwSCS.html

Medtronics Tame The Pain Website: http://www.medtronic.com/neuro/ttp/index.html

Here is a video for the Spinal Cord Stimulator: http://www.medtronic.com/neuro/ttp/neurostim_therapy_patient.html

Pain Control Pump: Intrathecal drug delivery is designed to reduce pain by delivering pain medication to the intrathecal space surrounding the spinal cord. Because this therapy delivers pain medication directly to the receptors in the spinal cord, smaller doses of medication are required to gain relief

Medtronics Tame The Pain Website: http://www.medtronic.com/neuro/ttp/index.html

Here is a video for the Pain Control Pump: http://www.medtronic.com/neuro/ttp/idd_therapy_patient.html

Ketamine Coma: The Ketamine Coma is an experimental treatment that is not FDA approved therfore it has to take place in either Germany or Mexico. Dr. Robert Schwartzman and Dr. Kirkpatrick. It is only for the worst of the worst of the RSD patients. They put you in a 7 day coma using Ketamine in hopes that it will re-set the pain signals in the brain.

http://www.mapinc.org/tlcnews/v05/n1371/a03.htm?158

http://www.webmd.com/video/ketamine-chronic-pain - Video on the coma, Web med  

http://www.rsds.org/3/treatment/ketamine.html - Ketamine Coma Infusion Therapy, RSDSA 

http://www.rsdfoundation.org/en/Anesthesiology.htm - Relief for Wrorst RSD May Lie With Ketamine Coma, RSD Foundation 

http://rsds.org/2/library/article_archive/pop/harbut_correll_IV_Ketamine.pdf - Ketamine Case Study, RSDSA 

http://rsds.org/2/library/article_archive/pop/ketamine_neurology_today.pdf - Neurology Today Ketamine Case Study, RSDSA  

http://www.youtube.com/watch? =n5aVCJ8-Ahw ->Disclaimer: The information on RSD in this video is not entirely accurate

http://www.rsdfoundation.org/en/Medical_Synopsis.htm - Medical Synopsis of Ketamine Coma Patients - RSDFoundation    

Physical / Occupational Therapy: Physical therapy is primarily used to strengthen muscles (although it can also be helpful for building bone density, improving circulation, improving nerve function and endurance). Physical therapy can be "the cure" for some RSD patients while others have no response or negative responses to physical therapy.

Also there is a lot of debate in the medical community to how much therapy an RSDer should get. Some argue children should get intense therapy daily while others think they should get 1 hour of therapy 3 times a week.

Physical Therapy and RSD- RSDhope Organization

http://www.rsds.org/3/treatment/PT_OT%20index.html - RSDSA PT/OT Treatment