Dr. Hooshmand's book states that the window of diagnoses and treatment is 6 months. I misread the book last week and stated 3 to 7 months but it is 6 months according to him. On that I disagree because I have seen people get better after not being diagnosed for years. If that were the case why would blocks be given later on in the diagnoses.

He also says there is 4 stages of RSD.

The first one is characterized by constant burning pain. It is aggravated by emotional stress.

The second one occurs between 3 to 7 months after the inury. The second stage is accompanied by vasoconstriction and coolness of the extremity. He states that the temperature difference is not as obvious in state 3 as in stage 2.

Stage 3 is advanced so that it is more easily diagnosed. It covers smooth and glossy skin, pale or cyanotic and dry skin, brittle nails, hypertrichosis, osteoporosis and pathologic fractures.

He also states that in the third stage that the patient can end up with depression, suicide, or unnecessary surgery which further aggravates the pain.

The 4th stage is caled the disastrous stage.

These stages are out of his book but came from a man named Bonica.

As far as treatments he talks about triggerpoint injections, nerve blocks, physiotherapy, early mobilization and goes on to talk about the meds used for RSD.

He says team work is the essential. Physiatrist, Anesthesiologist, and a Neurologist.

I think any Dr. that knows about RSD can help with it though. My PCP is my treating Dr. for the RSD. I also have a Anesthesiologist that does blocks if I need them.

I think councelling is important if a person is dealing with depression.

As far as PT I think a person must have a good one to help them with the RSD.

I was fortunate to have very good ones. I had 2 that started taking care of me and the girl was great then after they left I ended up with a Husband and Wife team that studied in Holland where they said that they believe more in massage and other things then physical therapy itself.

I do consider myself as close to remission as possible. I didn't get here overnight though. It took 4 years of PT to deal with the Fibro, TOS, back problems and the RSD. I had blocks that did help me a lot.

I realize a lot of people don't agree with a lot of Hooshmand but my Dr. used his book to do my medical care.

All of us on here have different ways of getting better and that's what it takes to get us each to where we need to be.

I'm on a small dosage of Methadone for the pain which helps most of the time.
Last winter was the hardest winter I ever had so I worry about this one. This summer I was miserable because of the heat. I sweat really bad from the RSD and if I get too hot I go into a pain cycle also. I stayed in most of the summer. We had a unusual summer for Co.

You asked these 2 questions and I wanted to give you some answers that I knew of.

Good luck in helping your wife with this. She is very lucky to have such a wonderful person in her life. I know how that is.

I hope she starts seeing some better days soon.

Ada

By the way, mine started in the right arm and hand from TOS surgery. I believe I had it before the surgery but the surgery just multiplied it and showed the other signs of it.