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-   -   is CRPS medically classified as a Mental Condition or Neurological??? (https://www.neurotalk.org/reflex-sympathetic-dystrophy-rsd-and-crps-/141068-crps-medically-classified-mental-condition-neurological.html)

CarlaDanDan 12-17-2010 07:13 PM

is CRPS medically classified as a Mental Condition or Neurological???
 
Hello out there!
hope you are all well
I have Peripheral Neuropathy and CRPS on my right foot injuried on a car accident 4 years ago.
I've been to Pain Management Team, on that time, when i was diagnosed and i remember the doctor explaining about my symptoms and treatment, and she said that medication would help, but also i could help myself psychologically (tapping to her head). Since them I've been trying my best in keep up, working on regenerate my nerve damaged and recover from Post Trauma.

Yesterday i had to review a legal medical report from a Psychiatrist about my Mental Health for Court

On the report he wrote about the Prognosis of my Chronic Pain and state that in his opinion he would expect a significant degree of recovery such that I can return to a fairly normal level of function within 9 months of the commencement of treatment...:confused:

sorry if my question sounds nonsense, i am not an expert :(
Please, do you know if Chronic Pain is a Mental Health Condition???,
i thought that was a Neurological Disorder? well, i am a layperson about my own condition, I never had opportunity to visit a Neurologist and i've been learning from Internet and from the little input of Doctors here in UK. "Health Studies" and our bodies are soooo complex to understand...we patients need help and information.
I would be greatfuly if you could comment about it and give your opinion too, also if you have experienced such a quickly recovery i would be more inspired. I really hope that he is right about timing:)
thanks in advance
lots of love

debbiehub 12-17-2010 09:42 PM

hi
 
CRPS is a pain condition that is very real and does come on do to any mental illness. The pain that you live with could lead to mental illness such as depression etc. As far as recovery, you should ask him where he got his information as for most of us this is a life time struggle..Hope that helps///

Jomar 12-18-2010 12:14 AM

Chronic & painful conditions are real.

Sometimes you can improve your situation and cope better with some mental /emotional techniques. Especially if pain is severe - therapy to learn coping skills is a plus.

Have you had any MRIs or xrays at all to rule out any possible spinal causes?

A true diagnosis is important with RSD or spinal issues- sometimes treatments can be done to slow or stop the problem.

Can you describe your symptoms?

CarlaDanDan 12-18-2010 12:40 PM

Quote:

Originally Posted by Jo*mar (Post 726769)
Chronic & painful conditions are real.

Sometimes you can improve your situation and cope better with some mental /emotional techniques. Especially if pain is severe - therapy to learn coping skills is a plus.

Have you had any MRIs or xrays at all to rule out any possible spinal causes?

A true diagnosis is important with RSD or spinal issues- sometimes treatments can be done to slow or stop the problem.

Can you describe your symptoms?

Thank you for your opinions!!! i also believed that pain is something real, and i agree that therapy helps to cope, but unfortunately didnt make it yet to magically disappear my pain.
I am in England, and did not have a MRI since got injuried, never visited a neurologist (NHS cutting costs:(). I had an EMG looong time ago, that showed Peroneal complications... I also received RF denervation. I have little information from doctor about my true diagnosis, except that talk in the past at Pain Clinic. Really learning from Internet, leaflets and support groups.

The symptoms at right lower leg, most concentrated on the foot, include stiffness, extreme temperatures sometimes is burning hot and some days like today is icing freezing cold, the nerve pain, pins and needles and constant numbness. Very poor circulation, lacks mobility, the swelling is low most of days, and sometimes i get cramps. My balance is bad, i describe my walking as a duck one! Since the accident there was improvements on sensations, moves, skin colour, pain and sweeling, all lessen, but still present and no improvements anymore, for two years now.

Im on Gabapentin 300mg and Tramadol 50mg 4 times a day. They can help to control the pain, but the stiffness never goes away and temperature is always different than good foot. I reduced my tablets with the help of weekly acupuncture sections (i highly recommend acupuncture to everyone who suffer with Pain). This winter pain and coldness is worsening and im question myself if i did right in reducing...
I will see a GP next 30th and will ask for referral to Pain Management (but i doubt he will give me) Its a lotery get appointments with specialist here. It was told me that to acess a private doctor is very expensive.

sorry for the long message, every help is very welcome
thank you for your support and patience in reading
lots of love

bobinjeffmo 12-18-2010 01:54 PM

There's nothing mental about RSD/CRPS whatsoever
 
There's nothing mental about RSD/CRPS whatsoever, it only feels that way at times:

Right now you're just in that common battle ground many of us have experienced when dealing with Worker's Comp or any other kind of legal battle where everyone at the table is trying to figure out a way to avoid any financial responsibility for your damage and/or health problems.

To deny there not being a psychological component to CRPS is ignorant as we watch our bodies and lifestyle change in ways we could never have dreamed possible, but that doesn't mean you've gone banana's, it only means you're going through the stages of surprise, denial, and acceptance that we've all gone through at one stage or another.

Don't let these lawyers try and blame your mental health as being the problem because they're wrong. Meanwhile hang on to your hat because whoever said our legal system is about finding the truth is living in Wonder Land. While RSD might not drive us crazy, the odds of surviving the legal system can be more than enough reason to find ourselves in a place where they lock us in tight each night and give us a cookie every afternoon around 3 while nurses pass out medication that puts the brain in la-la land. Hang tough and make sure you've got good legal representation and you will survive it, but the only mental health concern I have for you is in regards to our courts, never the RSD. Now please excuse me, I think I just heard the nurse say it's cookie time. Bob.

Quote:

Originally Posted by CarlaDanDan (Post 726705)
Hello out there!
hope you are all well
I have Peripheral Neuropathy and CRPS on my right foot injuried on a car accident 4 years ago.
I've been to Pain Management Team, on that time, when i was diagnosed and i remember the doctor explaining about my symptoms and treatment, and she said that medication would help, but also i could help myself psychologically (tapping to her head). Since them I've been trying my best in keep up, working on regenerate my nerve damaged and recover from Post Trauma.

Yesterday i had to review a legal medical report from a Psychiatrist about my Mental Health for Court

On the report he wrote about the Prognosis of my Chronic Pain and state that in his opinion he would expect a significant degree of recovery such that I can return to a fairly normal level of function within 9 months of the commencement of treatment...:confused:

sorry if my question sounds nonsense, i am not an expert :(
Please, do you know if Chronic Pain is a Mental Health Condition???,
i thought that was a Neurological Disorder? well, i am a layperson about my own condition, I never had opportunity to visit a Neurologist and i've been learning from Internet and from the little input of Doctors here in UK. "Health Studies" and our bodies are soooo complex to understand...we patients need help and information.
I would be greatfuly if you could comment about it and give your opinion too, also if you have experienced such a quickly recovery i would be more inspired. I really hope that he is right about timing:)
thanks in advance
lots of love


CarlaDanDan 12-18-2010 04:21 PM

Quote:

Originally Posted by bobinjeffmo (Post 726909)
There's nothing mental about RSD/CRPS whatsoever, it only feels that way at times:

Right now you're just in that common battle ground many of us have experienced when dealing with Worker's Comp or any other kind of legal battle where everyone at the table is trying to figure out a way to avoid any financial responsibility for your damage and/or health problems.

To deny there not being a psychological component to CRPS is ignorant as we watch our bodies and lifestyle change in ways we could never have dreamed possible, but that doesn't mean you've gone banana's, it only means you're going through the stages of surprise, denial, and acceptance that we've all gone through at one stage or another.

Don't let these lawyers try and blame your mental health as being the problem because they're wrong. Meanwhile hang on to your hat because whoever said our legal system is about finding the truth is living in Wonder Land. While RSD might not drive us crazy, the odds of surviving the legal system can be more than enough reason to find ourselves in a place where they lock us in tight each night and give us a cookie every afternoon around 3 while nurses pass out medication that puts the brain in la-la land. Hang tough and make sure you've got good legal representation and you will survive it, but the only mental health concern I have for you is in regards to our courts, never the RSD. Now please excuse me, I think I just heard the nurse say it's cookie time. Bob.

Thank you so much Bob for your words and contribution here
yes its a battle, sometimes a war!
battle with lawyers
battle with doctors to get right treatment
and between those stages you described i get very, very upset with these people (doctors and lawyers of mine, i know out there theres good ones), but luckily i've got lots lots of patience
but i keeping fight, even being a mere patient without a medical or law diploma! Im reviewing his report and making changes that i am not happy. So hopefully he will re-write this wrong (kind of insulting) prognosis
I will let you know
take care
lots of love
:hug:

SBOWLING 12-18-2010 04:29 PM

Hello,

I have been living with full body RSD/CRPS for 9 years. About three years ago my long term insurance company tried to cancel my claim. Their reason RSD/CRPS is a mental condition not physical. I had my doctors all write a letter explaining the conditon. They didn't cancle my benefits. Here is what my psychologist wrote to the insurance company.
I can state without reservations whatsoever that CRPS/RSD is a physical disorder. It is not believed to be psychological or psychocomatic in orgin. Althourgh there is considerable controversy as to the specific causes and mechanisms, it is a diagnosable physical disorder marked by dysfucntion of the autnomic nerves system, sever pain and disability and progressieve neruological and othopedic deterioration due to compromised blood flow. Although depression and stress are very common consequences of the ongoing chronic pain loss of function and inability to find difinitive medical care (as well as ignorance in the medical profession and by other as the real physical nature of disorder) it is completely accepted by all medical organizations of which I am aware as a completely real physical syndrome. Depression and stress are common consequences of the disorder, they are not its cause.
For some reason this letter was close to my computer so I thought I would share.
I hope you find the answers you need good luck and let me know if I can help.
Sherrie

CarlaDanDan 12-18-2010 05:46 PM

Quote:

Originally Posted by SBOWLING (Post 726948)
Hello,

I have been living with full body RSD/CRPS for 9 years. About three years ago my long term insurance company tried to cancel my claim. Their reason RSD/CRPS is a mental condition not physical. I had my doctors all write a letter explaining the conditon. They didn't cancle my benefits. Here is what my psychologist wrote to the insurance company.
I can state without reservations whatsoever that CRPS/RSD is a physical disorder. It is not believed to be psychological or psychocomatic in orgin. Althourgh there is considerable controversy as to the specific causes and mechanisms, it is a diagnosable physical disorder marked by dysfucntion of the autnomic nerves system, sever pain and disability and progressieve neruological and othopedic deterioration due to compromised blood flow. Although depression and stress are very common consequences of the ongoing chronic pain loss of function and inability to find difinitive medical care (as well as ignorance in the medical profession and by other as the real physical nature of disorder) it is completely accepted by all medical organizations of which I am aware as a completely real physical syndrome. Depression and stress are common consequences of the disorder, they are not its cause.
For some reason this letter was close to my computer so I thought I would share.
I hope you find the answers you need good luck and let me know if I can help.
Sherrie

Sherrie thank you so much, im glad that yours benefit was not cancelled. Justice exists.
God bless you immensely for share this letter. It helps me a lot. Information is really power. I will insist on the changing of that report with no doubt that CRPS/RSD is not a mental condition. Also that i dont agree with "9 months treatment will bring me back to normal function", i wish could.
I believed many people out there must think CRPS/RSD are mental conditions. Theres no pain awareness campaign enough i think. Here in England i am struggle to find support. Thanks to internet, i've being able to have help, from here too, also to be in touch with family abroad. Its just wonderful to be able to read about your victory.
thank you for the help
take care
:hug:

Carla

SnowWhyte 12-18-2010 06:00 PM

RSD Is Not Psychological!!!
 
I'm so sorry that you have this to battle, on top of all the pain of RSD! But know this: RSD is a Neurological (physical) disorder, it is NOT psychological! However, one of the many unique, and somewhat ironic characteristics of RSD is that it *in and of itself* can cause problems such as depression, irritability, sleep disturbances- because of RSD's link to the limbic system in the brain (which also controls emotion and sleep). So, on top of the fact that chronic pain, and a diagnosis such as RSD would make anyone depressed and have trouble sleeping, but the disease itself actually *causes* these feelings, as well as all the more prominent symptoms, such as intense nerve pain.

I'm no expert, but as I was recently dx with rsd/crps I've done my best to become one :eek:- I've spent nearly all day, every day researching, and trying to learn all I can about this- I've read many, many articles regarding RSD/CRPS, written by some of the top experts on the topic that thoroughly explain the disease, and they almost all agree that those emotional symptoms are indeed caused as a direct result of the disease.

But that isn't to say that the psychological issues caused by RSD should be ignored or brushed off either- emotional stress or pain is as real as the pain of the disease is. Do whatever you can to ensure you're treating both your physical and emotional self...but bottom line, don't let anyone "bully" you into believing that this is "all in your head", because if you start thinking that way, you really might just go crazy after all! (I think most of us felt that way to some extent at first- at least I did- but it's not, don't forget that!)

Best of luck to you! Don't give in to the "bullies"!! :hug:

hyperbaric1 12-19-2010 01:18 AM

Quote:

Originally Posted by CarlaDanDan (Post 726705)
Hello out there!
hope you are all well
I have Peripheral Neuropathy and CRPS on my right foot injuried on a car accident 4 years ago.
I've been to Pain Management Team, on that time, when i was diagnosed and i remember the doctor explaining about my symptoms and treatment, and she said that medication would help, but also i could help myself psychologically (tapping to her head). Since them I've been trying my best in keep up, working on regenerate my nerve damaged and recover from Post Trauma.

Yesterday i had to review a legal medical report from a Psychiatrist about my Mental Health for Court

On the report he wrote about the Prognosis of my Chronic Pain and state that in his opinion he would expect a significant degree of recovery such that I can return to a fairly normal level of function within 9 months of the commencement of treatment...:confused:

sorry if my question sounds nonsense, i am not an expert :(
Please, do you know if Chronic Pain is a Mental Health Condition???,
i thought that was a Neurological Disorder? well, i am a layperson about my own condition, I never had opportunity to visit a Neurologist and i've been learning from Internet and from the little input of Doctors here in UK. "Health Studies" and our bodies are soooo complex to understand...we patients need help and information.
I would be greatfuly if you could comment about it and give your opinion too, also if you have experienced such a quickly recovery i would be more inspired. I really hope that he is right about timing:)
thanks in advance
lots of love

Hello, It is both, it is a neurological disorder which is caused by a physical condition and causes more physical conditions. It is based in the brain however it will cause the blood flow to be deverted from the bone and tissue causing in some cases nerve and bone death I urge you to wisely consider HBOT For your condition.
Susan

bobinjeffmo 12-19-2010 10:57 AM

Please keep me posted
 
I would appreciate you keeping me posted on how you're doing both physically and legally. Between the two, I'm not the right one to ask which one is worse. Now just hang onto that great attitude of yours and try and not let corrupt people and the physical damage become your entire life. Even though we certainly live differently, it doesn't mean there's not a whole lot of life to live. Now go find some joy in the season! Bob.

Quote:

Originally Posted by CarlaDanDan (Post 726947)
Thank you so much Bob for your words and contribution here
yes its a battle, sometimes a war!
battle with lawyers
battle with doctors to get right treatment
and between those stages you described i get very, very upset with these people (doctors and lawyers of mine, i know out there theres good ones), but luckily i've got lots lots of patience
but i keeping fight, even being a mere patient without a medical or law diploma! Im reviewing his report and making changes that i am not happy. So hopefully he will re-write this wrong (kind of insulting) prognosis
I will let you know
take care
lots of love
:hug:


fmichael 12-20-2010 12:31 AM

in your head but not your mind
 
Hi there. For what it's worth, there is now fairly convincing proof that, once established - that is, beyond the point of remission - CRPS is maintained by a "thalamocortical dysrhythmia," which is to say a disruption/displacement of the oscillatory brain waves that define our experience. And the same is true of any number of conditions, Parkinson’s disease, depression, tinnitus, etc. And each has its unique pattern.

The article that’s taken the pain community for a loop (pun intended) came out of the laboratory of Rodolfo R. Llinás, who has been the chairman of the Department of Neuroscience at NYU for 34 years and (I am told) is widely regarded as one of the leading neuroscientists in the world. What the following Commentary in Pain by Edward Jones alludes to is that these concepts had been floating around for the last decade in the neurophysiology (EEG) literature, by were not picked up by the pain community until the NYU team specifically set its sights on CRPS.

Here it is: Walton KD, Dubois M, Llinás RR, Abnormal thalamocortical activity in patients with Complex Regional Pain Syndrome (CRPS) Type I, Pain 2010 Jul;150(1):41-51, FULL ONLINE TEXT @ http://www.rsds.org/2/library/articl..._Pain_2010.pdf:
Abstract
Complex Regional Pain Syndrome (CRPS) is a neuropathic disease that presents a continuing challenge in terms of pathophysiology, diagnosis, and treatment. Recent studies of neuropathic pain, in both animals and patients, have established a direct relationship between abnormal thalamic rhythmicity related to Thalamo-cortical Dysrhythmia (TCD) and the occurrence of central pain. Here, this relationship has been examined using magneto-encephalographic (MEG) imaging in CRPS Type I, characterized by the absence of nerve lesions. The study addresses spontaneous MEG activity from 13 awake, adult patients (2 men, 11 women; age 15-62), with CRPS Type I of one extremity (duration range: 3months to 10years) and from 13 control subjects. All CRPS I patients demonstrated peaks in power spectrum in the delta (<4Hz) and/or theta (4-9Hz) frequency ranges resulting in a characteristically increased spectral power in those ranges when compared to control subjects. The localization of such abnormal activity, implemented using independent component analysis (ICA) of the sensor data, showed delta and/or theta range activity localized to the somatosensory cortex corresponding to the pain localization, and to orbitofrontal-temporal cortices related to the affective pain perception. Indeed, CRPS Type I patients presented abnormal brain activity typical of TCD, which has both diagnostic value indicating a central origin for this ailment and a potential treatment interest involving pharmacological and electrical stimulation therapies.

PMID: 20338687 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/20338687

It’s pretty tough sledding though. The Commentary published with it is more accessible. Jones EG, Thalamocortical dysrhythmia and chronic pain, Pain 2010 Jul; 150(1):4-5, Epub 2010 Apr 14, FULL ONLINE TEXT @ http://www.rsds.org/2/library/articl..._Pain_2010.pdf

An earlier thread on this ran in August, in the context of Deep Brain Stimulation, especially for people with horrible dystonia: DBS (Deep Brain Stimulation) for RSD and Dystonia http://neurotalk.psychcentral.com/sh...d.php?p=685104

It's funny, but it appears that - essentially out of nowhere - the CNS aspects of CRPS/RSD have suddenly been laid bare for all to see.

Mike

cindi1965 12-20-2010 04:33 AM

Quote:

Originally Posted by CarlaDanDan (Post 726890)
Thank you for your opinions!!! i also believed that pain is something real, and i agree that therapy helps to cope, but unfortunately didnt make it yet to magically disappear my pain.
I am in England, and did not have a MRI since got injuried, never visited a neurologist (NHS cutting costs:(). I had an EMG looong time ago, that showed Peroneal complications... I also received RF denervation. I have little information from doctor about my true diagnosis, except that talk in the past at Pain Clinic. Really learning from Internet, leaflets and support groups.

The symptoms at right lower leg, most concentrated on the foot, include stiffness, extreme temperatures sometimes is burning hot and some days like today is icing freezing cold, the nerve pain, pins and needles and constant numbness. Very poor circulation, lacks mobility, the swelling is low most of days, and sometimes i get cramps. My balance is bad, i describe my walking as a duck one! Since the accident there was improvements on sensations, moves, skin colour, pain and sweeling, all lessen, but still present and no improvements anymore, for two years now.

Im on Gabapentin 300mg and Tramadol 50mg 4 times a day. They can help to control the pain, but the stiffness never goes away and temperature is always different than good foot. I reduced my tablets with the help of weekly acupuncture sections (i highly recommend acupuncture to everyone who suffer with Pain). This winter pain and coldness is worsening and im question myself if i did right in reducing...
I will see a GP next 30th and will ask for referral to Pain Management (but i doubt he will give me) Its a lotery get appointments with specialist here. It was told me that to acess a private doctor is very expensive.

sorry for the long message, every help is very welcome
thank you for your support and patience in reading
lots of love

Try asking for Baclofen for your stiffness. I have Cerebral Palsy and I have been taking it for years. I don't have the stiffness that other people have with their RSD. I was diagnosed 2 and a half years ago. It's too bad that you haven't seen a neurologist, because that is key with CRPS/RSD diagnosis, however I no longer see my neuro, because my GP does a better job at controlling my symptoms as he has MS.:hug:

Dubious 12-20-2010 01:17 PM

Quote:

Originally Posted by CarlaDanDan (Post 726705)
Hello out there!
hope you are all well
I have Peripheral Neuropathy and CRPS on my right foot injuried on a car accident 4 years ago.
I've been to Pain Management Team, on that time, when i was diagnosed and i remember the doctor explaining about my symptoms and treatment, and she said that medication would help, but also i could help myself psychologically (tapping to her head). Since them I've been trying my best in keep up, working on regenerate my nerve damaged and recover from Post Trauma.

Yesterday i had to review a legal medical report from a Psychiatrist about my Mental Health for Court

On the report he wrote about the Prognosis of my Chronic Pain and state that in his opinion he would expect a significant degree of recovery such that I can return to a fairly normal level of function within 9 months of the commencement of treatment...:confused:

sorry if my question sounds nonsense, i am not an expert :(
Please, do you know if Chronic Pain is a Mental Health Condition???,
i thought that was a Neurological Disorder? well, i am a layperson about my own condition, I never had opportunity to visit a Neurologist and i've been learning from Internet and from the little input of Doctors here in UK. "Health Studies" and our bodies are soooo complex to understand...we patients need help and information.
I would be greatfuly if you could comment about it and give your opinion too, also if you have experienced such a quickly recovery i would be more inspired. I really hope that he is right about timing:)
thanks in advance
lots of love


Hi,

I have not looked at prior replies so sorry if this is a repeat. ICD-9 codes are what (US) physicians use to catagorize diseases and conditions. They are usually lumped into "series" of types of diagnosis. Examples for CRPS are as follows (there are others):
355.9 Mononeuritis of unspecified site
Causalgia NOS
Complex regional pain syndrome NOS
Excludes:
causalgia:
lower limb (355.71)
upper limb (354.4)
complex regional pain syndrome:
lower limb (355.71)
upper limb (354.4)

354.4 Causalgia of upper limb
Complex regional pain syndrome type II of the upper limb
Excludes:
causalgia:
NOS (355.9)
lower limb (355.71)
complex regional pain syndrome type II of the lower limb (355.71)

337.20 Reflex sympathetic dystrophy, unspecified
Complex regional pain syndrome type I, unspecified
The general "series" is:
354 Mononeuritis of upper limb and mononeuritis multiplex

355 Mononeuritis of lower limb

337 Disorders of the autonomic nervous system
Includes: disorders of peripheral autonomic, sympathetic, parasympathetic, or vegetative system
Excludes: familial dysautonomia [Riley-Day syndrome] (742.8)

Regarding pain:

338 Pain, not elsewhere classified
Use additional code to identify:
pain associated with psychological factors (307.89)
Excludes:
generalized pain (780.96)
headache syndromes (339.00-339.89)
localized pain, unspecified type - code to pain by site
migraines (346.0-346.9)
pain disorder exclusively attributed to psychological factors (307.80)
vulvar vestibulitis (625.71)
vulvodynia (625.70-625.79)

338.29 Other chronic pain

338.21 Chronic pain due to trauma

338.4 Chronic pain syndrome
Chronic pain associated with significant psychosocial dysfunction

So using ICD-9 indexing, CRPS would be classified as a neurological disorder, whether these codes make sense or not, at least by the AMA. There are of course, various psychological complications in some cases.

Hope this helps!


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