Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 04-17-2007, 01:27 PM #1
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Default Need advice!!!

I slipped on ice and fell two months ago and have been having pain on and off as well as muscle tightness and tenderness (some spasms) in my neck, shoulders and arms (both sides). Three weeks ago I went to see neurologist and my first diagnostic was RSD. A week after I went back to see the doctor and this time she said I might not have RSD because I was doing better. She told me to keep doing exercises to strengthen the muscles.
I was wondering what symptoms of RSD at the early stage are. I don't have pain all the time. I noticed that if I use my arms and hands too much, I sense the pain but I can tolerate it. Is the pain at early stage unbearable? I would like to take precaution and wanted to find out whether I have RSD or not so that I could get treatment right away. I have little knowledge on early symptoms. Please adivse.


Greatly appreciated,
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Old 04-17-2007, 02:03 PM #2
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Did you land on your arms or shoulders?
- I almost wonder if you might have Thoracic Outlet Syndrome instead of RSD.

TOS forum-
http://neurotalk.psychcentral.com/forumdisplay.php?f=24
TOS useful links thread-
http://neurotalk.psychcentral.com/showthread.php?t=84

There are use links on this forum too that will describe most of the common symptoms-
http://neurotalk.psychcentral.com/showthread.php?t=247
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Old 04-17-2007, 05:19 PM #3
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Quote:
Originally Posted by jo55 View Post
Did you land on your arms or shoulders?
- I almost wonder if you might have Thoracic Outlet Syndrome instead of RSD.

TOS forum-
http://neurotalk.psychcentral.com/forumdisplay.php?f=24
TOS useful links thread-
http://neurotalk.psychcentral.com/showthread.php?t=84

There are use links on this forum too that will describe most of the common symptoms-
http://neurotalk.psychcentral.com/showthread.php?t=247
Hi there. I think you should think about what Jo said (above), and I was wondering... do you have any of the typical RSD symptoms (color/ temp changes, allodynia/ hyperalgesia, swelling)?

You mentioned tenderness, but it is not unbearable pain when someone touches you, or the breeze blows against your skin, etc? There is a difference between allodynia and tenderness! RSD typically has allodynia (one of the main symptoms).

Allodynia is:

Allodynia, meaning "other pain", is an exaggerated response to otherwise non-noxious stimuli and can be either static or mechanical. Allodynia is not referred pain and can occur in other areas that are not stimulated; it is also dysesthetic.

For example, a person with allodynia may perceive light pressure or the movement of clothes over the skin as painful, whereas a healthy individual will not feel pain.

One explanation of the mechanism for allodynia is that the associated nerve damage results in decreased firing thresholds of nociceptive fibres.

Alternatively, it has been postulated that peripheral nerve injury could induce collateral sprouting of non-nociceptive primary afferent neurones, such as A-beta low threshold mechanoreceptors, into the superficial (nociceptive) laminae in the dorsal horn of the spinal cord. These collateral branches could form functional contacts with nociceptive second order neurones, normally innervated by C-fibre nociceptive primary afferent neurones and transmit an innocous input as noxious.

Allodynia is a clinical feature of pain conditions such as migraine, postherpetic neuralgia, and neuropathies.

There are different kinds or types of allodynia:

* Mechanical allodynia (also known as tactile allodynia) - Pain from light touch/pressure applied to the skin in the area of the damaged nerve. Mechanical allodynia can be dynamic or static.
* Thermal (heat or cold) allodynia - Pain from normally mild skin temperatures in the affected area.
(see: http://en.wikipedia.org/wiki/Allodynia)


Just some thoughts... if you could tell more about your symptoms, that might be helpful. I am wondering as well, if you have RSD for real or if it may be something other? --shrug--

Welcome here, anyways!
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Old 04-17-2007, 05:25 PM #4
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Just another thought here-

I also thought I should mention... in the beginning with my RSD it came on slowly with tenderness and pain like you are describing (after a thumb injury and after slipping and falling in the snow)... and then progressed to severe pain and extreme allodynia (though in the beginning it *was* just tenderness and intermittant pain).

I wouldn't rule out that it isn't RSD just because of my personal experience.

I am no Dr. so I can't be sure if you have RSD or not, but I hope some of what I have said has helped.
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Old 04-17-2007, 06:36 PM #5
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First of all thanks for your advice. Here're my detailed symptoms - hopefully you don't get bored first... it's quite a long story
When I fell, I landed on butt and left hand and right hand was carrying bag and purse. After the fall, I was fine and able to drive home but the next day I had terrible pain at my bottom and back. For about two weeks or so I had less pain at the back but I noticed more pain in neck and right shoulder as well as numbness in right arm. I started having hard time walking and keeping my body in straight position because of the pain in neck and right shoulder. I went to see internal med doctor and had accupunture as well but it didn't help so I went to see orthopedist. The orthopedist said I have pinched nerve so he wanted me to have physical therapy for a month. The therapy didn't work well because I wasn't able to tolerate the pain (my therapist was very frustrated ). After having therapy for three weeks, I went back to see orthopedist again because I didn't feel any better and noticed that I had blood circulation problem in my right hand when the pain was really bad. I noticed that my right hand turned red - purpleish but if I raised my hand up, the color looked normal. Anyway, orthopedist sent me for MRI. The MRI doesn't show any abnormality but he suggested me to see neurologist and pain management specialist. So I went to see neurologist and was frist diagnosed with RSD. The neurologist also did EMG test but found nothing. She also prescribed medol pak (steroid - same medication that was prescribed by orthopedist). After seeing neurologist I started getting better. I've had less pain in neck and shoulder and was able to walk like normal people (no more limping) and no more blood circulation problem. However, I still have tightness in neck and tenderness in shoulders.

That's it for my story..... really long one, right? Anyway, my current pain level is 3-4 and it's not really a burning pain - sometimes it's more like aching and dull pain but I sensed burning pain sometimes. I'm not sure whether burning pain is always the case of RSD. I don't see any swelling and don't think I have allodynia. The neurologist said it's too early to tell though...

InHisHands - how long did it take for you to progress to severe pain?

Thanks again for all your advice and supports
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Old 04-17-2007, 10:35 PM #6
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here's some TOS links-

http://www.nismat.org/ptcor/thoracic_outlet/
http://www.medifocushealth.com/RT017/index.php

and have you thought about chiropractic?
you may have jammed something or gotten a misalignment- MDs don't really deal with this unless surgery is needed-
Chiropractic care info- a good one can help with many symptoms:
http://www.upcspine.com/self.htm
http://www.uppercervical.org/subpag...b/about_faq.php
http://www.spineuniverse.com/index.html
http://www.coloradochiropractic.org/.../glossary.html

What was the therapy that they did?
Like - did they do heat, ice, massage, or ultrasound to reduce the pain first?
before progressing to more active therapy?
- or did they start you right on to machines, exercises, weights and stretchy bands?
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Last edited by Jomar; 04-17-2007 at 10:54 PM.
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