We are all different, I have cold RSD, always did. Immediately following my release from the hospital from my bunion surgery my foot turned to a terrible deep in my bones ice cold burning. This was 4 days following my bunion surgery, in the hospital I was on a morphine pump, at home all I had was tylenol 3's. Despite all my complaints the orthopedic surgeon just kept scratching his head and called me a slow healer, for over 6 months. He insisted that I comply with icing my foot and doing extreme baths despite the increased pain.
To this day I still can't stand to walk on any surface barefooted that is in the least bit slightly cool. Heat for me is my saviour and I use a hot water bottle and hot wax every day to keep my foot warm. I gave up on electric heating pads when my last one inadvertently caught on fire when I forgot to turn it off.
There is some research out of the Netherlands that suggests that N-acetylcysteine (NAC) has some benefits for those with cold CRPS 1 in comparison the use of DSMO which had better effect for those with warm CRPS.
I started a trial of the NAC just over a month ago and I have to admit I am more tolerant of cooler temperatures right now.
http://www.ncbi.nlm.nih.gov/pubmed/12670672
Pain. 2003 Apr;102(3):297-307.
The treatment of complex regional pain syndrome type I with free radical scavengers: a randomized controlled study.Perez RS, Zuurmond WW, Bezemer PD, Kuik DJ, van Loenen AC, de Lange JJ, Zuidhof AJ.
Department of Anesthesiology, Vrije Universiteit Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
rsgm.perez@azvu.nl
To compare the effects of two free radical scavengers, dimethylsulfoxide 50% (DMSO) and N-acetylcysteine (NAC), for treatment of complex regional pain syndrome I (CRPS I), a randomized, double-dummy controlled, double-blind trial was conducted. Two outpatient clinics of two university hospitals in The Netherlands participated in the study and 146 patients, were included over a period of 24 months. Patients were randomized into two treatment groups, one was instructed to apply DMSO 50% five times daily to the affected extremity, the second was treated with NAC 600mg effervescent tablets three times daily, both combined with placebo. Interventions were accompanied by pain medication, occupational therapy for upper extremity CRPS I and physical therapy for lower extremity CRPS I in specific circumstances. Treatment was given for 17 weeks, with a possibility to continue or switch medication after this period, up to 1 year following the onset of treatment. An impairment level sum score was the primary outcome measure. Upper and lower extremity skills and functions, and general health status were also evaluated. Overall, no significant differences were found between NAC and DMSO after 17 and 52 weeks on impairment level and general health status. Significant differences were found for subscores of lower extremity function, in favor of DMSO-treatment. Subgroup analysis showed more favorable results for DMSO for warm CRPS I and significantly better performance of NAC for patients with a cold CRPS I. Results tended to be negatively influenced if the duration of the complaint was longer. Treatment with DMSO and NAC are generally equally effective in treatment of CRPS I. Strong indications exist for differences in effects for subgroups of patients with warm or cold CRPS I: for warm CRPS I, DMSO-treatment appears more favorable, while for cold CRPS I, NAC-treatment appears to be more effective.
PMID: 12670672 [PubMed - indexed for MEDLINE]
MsL