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 10-22-2013, 04:07 AM #1
BostonFern BostonFern is offline
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Default Do I have RSD?

I've been wondering whether I have RSD. I hope the experts here can help me identify.

About 8 months ago, I had a problematic blood draw on my right arm. To make a long story short, the phlebotomist put a bandaid on the puncture site, while the proper procedure calls for something that causes pressure.

I developed a big hematoma because of this none-pressure bandaid. (Hematoma, according to my online research, can damage nerve.) I started to have pain when I bend the right arm backwards or pull it down when it's holding onto something. Fortunately, these movements are infrequent in my daily life, so I waited patiently for the healing of the nerve.

In the meantime, I noticed my right hand sometimes becomes stiff in the morning, a symptom that's very common today.

For about 5 months, these pain didn't get better or worse, until I tried out folk dancing, which involved some arm-pulling movements. It were moments of pain while I danced, but seemed temporary. After the 4th time I danced, I noticed new pain that haven't gone away: elbow pain when I flex the forearm, or when I extend my right arm to grab things. When I pressed different spots of forearm and arm, there were pain too. Throughout the day I would have many cries of pain. All these pain started about 6 weeks ago.

I thought the new pain was caused those arm-pulling movements, so I stopped folk dancing. About a week ago I went to a weekend of light dancing workshop. The only hand movements were clapping of hands, which don't cause pain and should be ok, according to my speculation back then. Still, after this workshop, I developed new pains: sometimes pain on the right neck, or sometimes constant pain on the right upper arm, or pain on the right shoulder. I now think it's because I over-exercised my right arm.

Besides these pain, during the last 6 weeks, I sometimes feel I have arthritis on my right arm. I don't sleep very well at night, because I have to avoid certain posture that causes pain.

So it seems, each time I exercise my arm for a few hours, my pain become more wide-spread. I don't have any sensitivity issues, nor do I notice any skin changes.

Do you think I have RSD? I also wonder whether RSD is a curable illness.

Thank you very much for your help.
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Old 10-22-2013, 07:48 AM #2
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Hi there

Sounds like you're going through a really difficult time, which we can all understand. It's horrible when you know something is wrong but no one seems able to help you, either by knowing what it is, or actually trying to make it better it's enormously frustrating.

I am not a doctor, and only a CRPS specialist can diagnose you, but I'll happily give you my opinion

There could be so many types of damage to your arm from what you describe. Nerve damage itself can vary as well, and to be honest, what you describe doesn't sound like classic CRPS.....however, there's a chance it still could be, given that CRPS can present without the colour changes, temperature changes etc. and be mainly present as the pain itself. It's very complex...hence the name!

You don't mention any doctors - have you had any investigations to find out what's happening with your arm? If not, I would go and see your doctor urgently and get the ball rolling. It's obviously worrying you, and you need to find out what's going on. It's impossible for you to diagnose it yourself successfully, and you will only add to your anxiety if you look around the web trying to find a condition that fits your symptoms (though i do understand why). Your doctor should be able to help you with some pain relief too.

What you describe could be so many things, but if your doctor is unable to find a mechanical reason for your pain, you can certainly request a referral to a specialist with expertise in CRPS and find out from them. Hopefully they can put your mind at rest and whatever is wrong with your arm can be treated. In the meantime, I would avoid any vigorous arm movements and don't use ice on that arm, but keep it gently moving to help circulation. Good luck, and let us know how you get on

Bram.
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Old 10-22-2013, 12:32 PM #3
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Hey BostonFern! I agree with Bram, she gave you some great advice. You defiinitely need to get checked out by a dr if you haven't already.

To me, it sounds more like a nerve issue than RSD. But only a doctor can tell you. In 2007, I developed venipuncture RSD in my left arm when I was donating blood and the phlebotomist missed my vein and punctured the nerve. My pain didn't invlove my neck but did involve my arm from above my elbow to below my elbow. I went to the dr as soon as the pain and weakness started. Dr gave me injections and sent me to PT, both helped.

And to answer your other question, no, there is no cure for RSD/CRPS.

Hope you can get some relief soon!
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Old 10-22-2013, 10:28 PM #4
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For a diagnosis of RSD/CRPS you are required to have 3 of the 4 main symptoms. If you have I sugest you print this out and take it to your doctor.


The Symptoms
There are FOUR Main Symptoms/Criteria for a diagnosis of CRPS:
• Constant chronic burning pain - (includes allodynia; extreme sensitivity to touch, sound, vibration, wind, etc.)
• Inflammation - this can affect the appearance of the skin, bruising and mottling for example.
• Spasms-in blood vessels and muscles of the extremities
• Insomnia/Emotional Disturbance (including limbic system changes such as short-term memory problems, concentration difficulties, and irritability)
Not all four symptoms are required for a diagnosis but most patients do have at least three out of the four at any one time. What makes this disease even more difficult for Drs to diagnose and treat is that patients can present with different symptoms at different times, even from one appointment to the next.

The CONSTANT PAIN can be described as burning pain as if a red hot poker were inserted into the affected area; as well as throbbing, aching stabbing, sharp, tingling, and/or crushing in the affected area (this is not always the site of the trauma). The affected area is usually hot or cold to the touch. The pain will be more severe than expected for the type of injury sustained. This is a hallmark of the disease. Allodynia is usually present as well (extreme sensitivity to touch). Something as simple as a light touch, clothing, sheets, even a breeze across the skin on the affected area can cause an extreme amount of pain to the patient. Pain can also be increased by sounds and vibrations, especially sharp sudden sounds and deep vibrations. This makes it increasingly difficult on the spouses, children, and other family members; as their softest touch can now cause pain instead of comfort. If the patient has not been properly diagnosed yet and these sensations not properly explained, these symptoms can cause extreme duress and confusion to all involved.

The INFLAMMATION is not always present. It can take various forms, the skin may appear mottled, become easily bruised, bleeding in the skin, small red dots, have a shiny, dry, red, and tight look to it. An increase in sweating usually occurs as well as swelling in and around the joints (shoulders, knees, wrists). In some patients a lack of sweating may also occur, and may even go back and forth between the two.

The SPASMS result in a feeling of coldness in the affected extremity as well as body fatigue, skin rashes, low-grade fever, swelling (edema), sores, dystonia, and tremors. The spasms can be confined to one area or be rolling in nature; moving up and down the leg, arm, or back.

The fourth part of this square is INSOMNIA and EMOTIONAL DISTURBANCE. CRPS affects the limbic system of the brain. Doctor Hooshang Hooshmand described it well; " The fact that the sympathetic sensory nerve fibers carrying the sympathetic pain and impulse up to the brain terminate in the part of the brain called "limbic system". This limbic (marginal) system which is positioned between the old brain (brainstem) and the new brain (cerebral hemispheres) is mainly located over the temporal and frontal lobes of the brain." This causes many problems that might not initially be linked to a disease like CRPS. Chief among them are Depression, Insomnia and short-term memory problems. CRPS can cause Depression, NOT the other way around.


ADDITIONAL SYMPTOMS

There are many additional symptoms that can be part of CRPS besides the four main ones. These include but are not limited to;

- Changes in skin temperature (warmer or cooler compared to the healthy/opposite limb.
- changes in skin color (skin may appear red, dusky, covered with red dots, cyanotic, blotchy, or pale).
- hypersensitivity to touch, sound, vibration, wind, noise, temperature, barometric pressure changes, water temperature, etc.
- irritability.
- depression, fatigue, and/or insomnia.
- changes in hair/nail growth (nails can become brittle, cracked, or grooved - increased/decreased hair/nail growth).
- skin can become shiny, changes in sweating patterns - increase/decreases
- bone and muscle loss/changes, atrophy/weakness.
- swelling and stiffness in affected joints.
- throbbing, crushing, tingling, shooting, aching, stabbing, burning pain in the affected area.
- tremors (shakes).
- problems moving the affected extremity/body part.
- migraines/cluster headaches.

These symptoms can come and go and alternate over time, changing from month to month and year to year depending what stage the patient is in
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Old 10-24-2013, 11:50 PM #5
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Thank you for your thorough replies. I really appreciate your support.

I saw a physical therapist yesterday and she doesn't think I have RSD.

I found that, if I don't press/sqeeze my right arm to feel or lessen the pain, my arm pain wouldn't last as long. So it seems like a nerve issue.

I have issues with sleep. and it's mainly because I have limited sleep positions due to my painful arm and shoulder.

Thank you again.
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Old 10-25-2013, 01:01 AM #6
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When I was first diagnosed with rsd in my right wrist and hand I had alot of pain to the slightest touch, burning to the slightest touch, excessive swelling, excessive dark and long hair growth on the back of my hand and wrist, a dark purple color on my hand and wrist that almost looked dark gray at times, like gangreen and sometimes it turned bright red. My skin was very shiny too. I was unable to straighten my fingres or bend my wrist or straigten my elbow or move my hand and arm towards my back all the way and had terrible spasms in my shoulder. I couldn't even lift a piece of paper without extreme pain. It was a deep aching, burning, stabbing spasming pain. Not all at the same time, but always some sort of a contant pain. I'm not a dr but what you have sounds maybe more like arthritis. You may want to get bloodwork to see if that is the case. My pm dr and nuerologist confirmed my rsd not only by the internal pain but the external symptoms as well. I would get your pain checked out anyway just to rule it out. Some drs have told me that when theres a rsd spread, the symptoms are not always external. They can be just internal like terrible burning or a deep aching pain. I hope you find out what's wrong soon and feel better. And I hope you don't have rsd. Take care.

PS - I also was up most of the night, like tonight, because of the pain.
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Old 10-25-2013, 09:16 PM #7
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Quote:
Originally Posted by Kevscar View Post
For a diagnosis of RSD/CRPS you are required to have 3 of the 4 main symptoms.
Geeze I feel like an overachiever lol, I have every single symptom you've listed, including the additional ones.

Everyone here has given you good direction. I hope you find some help and answers soon.
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