Quote:
Originally Posted by cja1
Hi Mike!
This is all very interesting. I have a quick question: if someone with CRPS goes into remission for a period of time (about a year) and comes out of it, would the resulting neurological condition be more similar to "fresh" CRPS or "old and cold"... i.e. if you went into remission and came out of it would these acute treatments offer the potential of a cure in the same way that they would to people who literally just started showing signs of CRPS?
Thanks for all this information! Your hard work is much appreciated!
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Good question. If the CRPS returns after a new injury of some sort, then I'm pretty sure it's a fresh or "acute" case of CRPS in its own right. As would be the "spread" of CRPS in such circumstances, where a good argument can be made that each case of "spread" secondary to a new injury, is in fact a fresh immune-modulated case of CRPS, on account of which treatments that may have long since lost their effectiveness, such as nerve blocks delivered under fluoroscopy - may have a new lease on life with respect to combating injury-induced spread.
For the complete treatment of whatever it is I happen to know on the subject, including links and citations to some articles of interest, please check out my post from February of this year - "a few quick points on spread" - in the
t.D.C.S. Update Could remission be within my reach and your's too? thread, which appears as Post No. 145.
But as to a re-occurrence independent of any injury, I don't know. One way to find out (and treat it should the response be positive) would be if it responded to a nerve block within three months of the re-occurrence. If so, it would be a fresh case, not unlike those reports of CRPS independent of any known injury. Alternatively, a rheumatologist's blood test for
TNF-[alpha] and its soluble Receptors I/II should be close to dispositive if performed within six months of symptom re-occurrence. See, Systemic inflammatory mediators in post-traumatic complex regional pain syndrome (CRPS I) - longitudinal investigations and differences to control groups, Schinkel C, Scherens A, Köller M, Roellecke G, Muhr G, Maier C,
Eur J Med Res. 2009 Mar 17;14(3):130-5
[ABSTRACT]. This study is important because it found a significant difference in these serum levels (among others) (
p = 0.01)
in the same patients, from the time their cases were "acute" (defined as being within 6 months of symptom onset) as opposed to when they had become "chronic"
(remarkably in the relatively narrow band of only 6 - 12 months from onset).
(And while I'm sorry there isn't a link to the full text of the Schinkel article - which a friend pulled for me - I will be happy to send on a copy of the PDF to anyone who drops me a PM
with an email address.)
I hope this is useful.
Mike