I realize my posts are difficult to read, but before you dismiss them out-of-hand, look at the similarities between RSD and IRI in these abstracts:

1: Lancet. 1999 Dec 11;354(9195):2025-8.

Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial.

Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS.

Department of Orthopaedics, Leyenburg Hospital, The Hague, The Netherlands.

BACKGROUND: The pathogenesis of reflex sympathetic dystrophy (RSD) is not clear, nor is there a definitive treatment for this syndrome. The morbidity, costs in health care, and loss of work time justify the search for a means to prevent post-traumatic dystrophy. Although the role of toxic oxygen radicals has not yet been clarified, we investigated vitamin C (ascorbic acid) as a prophylactic antioxidant drug. METHODS: 123 adults with 127 conservatively treated wrist fractures were randomly allocated in a double-blind trial to take a capsule of 500 mg vitamin C or placebo daily for 50 days. Each participant's sex, age, side of fracture, dominance, fracture type, dislocation, reduction, and complaints with the plaster cast were recorded, and they were clinically scored for RSD. The follow-up lasted 1 year. FINDINGS: Eight patients were withdrawn after randomisation. 52 patients with 54 fractures (male 22%, female 78%; mean age 57 years) received vitamin C and 63 patients with 65 fractures (male 20%, female 80%; mean age 60 years) received placebo. RSD occurred in four (7%) wrists in the vitamin C group and 14 (22%) in the placebo group 15% (95% CI for differences 2-26). Other significant prognostic variables for the occurrence of RSD were complaints while wearing the cast (relative risk 0.17 [0.07-0.41]) and fracture type (0.37 [0.16-0.89]). INTERPRETATION: This prospective, double-blind study shows that vitamin C was associated with a lower risk of RSD after wrist fractures. Our hypothesis is that this beneficial effect of prophylaxis would be useful in other forms of trauma.



J Bone Joint Surg Br. 2001; 83(8):1202-6 (ISSN: 0301-620X)
Oral vitamin C attenuates acute ischaemia-reperfusion injury in skeletal muscle.

Kearns SR; Moneley D; Murray P; Kelly C; Daly AF: Cappagh Hospital, Dublin, Ireland.

Ischaemia-reperfusion injury (IRI) is caused by endothelial and subendothelial damage by neutrophil-derived oxidants. Vitamin C is an antioxidant which attenuates endothelial injury after IRI. Our aim was to evaluate the effect of oral vitamin C in the prevention of IRI in skeletal muscle. We used a model of cross-clamping (3 hours) and reperfusion (1 hour) of the cremaster muscle in rats. Muscle function was assessed electrophysiologically by electrical field stimulation. Infiltration by neutrophils was determined by the activity of tissue myeloperoxidase (MPO) and tissue oedema by the wet-to-dry ratio. Neutrophil respiratory burst activity was measured in control animals and groups pretreated with vitamin C. IRI significantly decreased muscle function and increased muscle neutrophil MPO activity and muscle oedema. Pretreatment with vitamin C preserved muscle function and reduced tissue oedema and neutrophil infiltration. Neutrophil respiratory burst activity was reduced in the group treated with vitamin C compared with the control group. We conclude that pretreatment with oral vitamin C protects against acute muscle IRI, possibly by attenuating neutrophil respiratory burst activity.

neutrophil respiratory burst activity describes the activation of OFRs in the white blood cells.

It could be coincidence; OFRs have been identified in more than 100 disease processes that have nothing to do with RSD, but since both RSD and IRI always begin with a physical trauma, it might be worth investigating a possible link.

I was just thinking about this today.

Alone this means nothing but with the other evidence it does seem to paint a picture.

Very interesting. There are many things in common with these two. Both involve an inflammatory response, hypoxia and histamine has a part to play. I suspect the common cause is inflammation not necessarily that they are connected. However I don't know much about IRI so it's just a guess.
I note the research on vitamin C for preventing CRPS post wrist fractures. Further research has been done on this. Professor Scott Reuben now includes vitamin C in the protocols for preventing CRPS post tissue trauma and orthopedic surgery. I also use it post dental work.

Vitamin C is the antioxidant which demolishes inflammation causiong free radicals. Certain things/situations cause the body to make more of these inflammation causing free radicals. Trauma is one stress another. Infact I suspect that people who have a lot of artery blockage may in part blame these free radicals. Stress has a big part to play I believe.

Remember that vitamin C becomes itself a free radical when it demolishes inflammatory causing free radicals. The sensible thing is to have a range of antioxidants to maintain a balance. Personally I believe the safest way to get these is from a diet rich in antioxidants.

However if you have chronic pain it is now known that the brain changes with this kind of pain. The answer for us now lies with retraining the brain to stop the messages from the brain saying that it hurts. Mirror therapy is one way of doing this. It's now used with stroke patients to retrain brain and improve function.

I think the more people who are prepared to think outside the box as you have Vic, the better the outcome for us all.

jeisea

http://www.crps-rsd-a-better-life.blogspot.com