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| 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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08-03-2007, 08:59 PM
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Magnate
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THE old cover all term of RSD is one that is out dated and doctors that specialize can tell us which type affects us. Complex Regional Pain Syndromes I and II
There are some excellant articles out there for us to read; and consult with our own TOP specialist. Dianne Complex regional pain syndromes: including "reflex sympathetic dystrophy" and "causalgia".Walker SM, Cousins MJ. University of Sydney, Pain Management and Research Centre, Royal North Shore Hospital, N.S.W. "Reflex sympathetic dystrophy" and "causalgia" are now classified by the International Association for the Study of Pain as Complex Regional Pain Syndromes I and II. Sympathetically maintained pain is a frequent but variable component of these syndromes, as the sympathetic and somatosensory pathways are no longer functionally distinct. Pain is the cardinal feature of CRPS, but the constellation of symptoms and signs may also include sensory changes, autonomic dysfunction, trophic changes, motor impairment and psychological changes. Diagnosis is based on the clinical picture, with additional information regarding the presence of sympathetically maintained pain or autonomic dysfunction being provided by carefully performed and interpreted supplemental tests. Clinical experience supports early intervention with sympatholytic procedures (pharmacological or nerve block techniques), but further scientific data is required to confirm the appropriate timing and relative efficacy of different procedures. Patients with recurrent or refractory symptoms are best managed in a multi-disciplinary pain clinic as more invasive and intensive treatment will be required to minimize ongoing pain and disability. PMID: 9127652 [PubMed - indexed for MEDLINE] 1: Neurol Clin. 1998 Nov;16(4):851-68.Links Traumatic neuralgias: complex regional pain syndromes (reflex sympathetic dystrophy and causalgia): clinical characteristics, pathophysiological mechanisms and therapy.Wasner G, Backonja MM, Baron R. Klinik für Neurologie, Christian-Albrechts-Universität Kiel, Germany. Complex regional pain syndromes (CPRS) may develop as a disproportionate consequence of a trauma affecting the limbs without (CRPS I, reflex sympathetic dystrophy) or with (CRPS II, causalgia) obvious nerve lesions. The clinical picture of CRPS consists of asymmetrical distal extremity pain, swelling, and autonomic (sympathetic) and motor symptoms. Changes in the peripheral and central somatosensory, autonomic and motor processing, and a pathologic interaction of sympathetic and afferent systems are discussed as underlying pathophysiologic mechanisms. Therapeutic strategies include pharmacologic pain relief, sympatholytic interventions, and rehabilitation. 1: Schmerz. 2003 Jun;17(3):213-26. Links [Complex regional pain syndrome. Sympathetic reflex dystrophy and causalgia][Article in German] Baron R, Binder A, Ulrich W, Maier C. Universitätsklinik für Neurologie, Christian-Albrects-Universität, Kiel. r.baron@neurologie.uni-kiel.de Complex regional pain syndromes (CRPS) occur as the inadequate response to painful trauma in a distal extremity.With CRPS I (sympathetic reflex dystrophy), no lesion of the nerve is present. Aside from sensory disturbances, burning deep spontaneous pain and mechanical allodynia are characteristic.Disturbances in the skin blood circulation,sweating,edema,and trophic disturbances of the skin, joints, and bones are typical.Reduction in muscle strength, tremor, and late dystonic changes comprise the motor disturbances.All symptoms are distributed in the distal extremity and not limited to the region of the peripheral nerves.Complex regional pain syndrome II (causalgia),develops following a partial peripheral nerve lesion.The distally generalized symptoms are identical.Successful therapy depends on an early start of interdisciplinary treatment.In addition to the pain therapy,physiotherapy plays a decisive role in rehabilitation. During the acute phase, freedom from pain at rest and retrogression of the edema must be achieved.With slight spontaneous pain, a conservative therapeutic method may be applied (analgesics, rest, raised position). In case of insufficient improvement and in difficult cases, the effect of intervention (sympathetic blockade) should be tested and possibly a blockade series performed.After reduced spontaneous pain,physiotherapy should be increased stepwise. PMID: 12789489 [PubMed - indexed for MEDLINE]
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If doctors have trouble with CRPS I and II so can we
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