[Summertime]

Hi

I heard a little about the alcohol swipe test. What is this?
My doctor did this but didn't explain it to me, Can anyone tell me about this test?

Thanks

[Abbie]

I had a doctor tell me that alcohol swipe test was a definitive test (in his opinioin) to determine if someone truly has RSD or not.

I've had several doctors do this to me with the same results....
How I reacted to the alcohol being on my skin was the test for the docs....

I definitely have RSD.


What did you feel when your doctor did this to you???

[Desi]

To my knowledge.. there are NO tests for RSD, where did you hear this from?? new one on me,

[Jomar]

I found this about it-
[Hendler Alcohol Drop and Swipe Test (7). In this test, a physician squeezes an alcohol swab so that a drop of alcohol lands on the patient's affected area. If the patient immediately withdraws the limb and complains of a burning pain, the physician has demonstrated thermal allodynia, i.e. a painful response to the cooling effects of a drop of alcohol on a limb. After two minutes, if there has been no response to the thermal test, a patient may begin to experience burning pain in the affected limb. This occurs as the fat soluble alcohol permeates the skin and begins to chemically irritate the hypersensitive C fibers, which conduct the message of pain. If the patient then experiences pain, this demonstrates chemical allodynia. Then, with the leftover alcohol swab, the physician gently strokes the affected area. If this produces pain, this clearly demonstrates mechanical allodynia. In order to establish the diagnosis of RSD (CRPS 1)]
http://209.85.173.104/search?q=cache...ient=firefox-a

[Summertime]

Hi

This was an IME (comp doctor) he states I had no reaction to this test. Those doctors are being paid by the insurance company which irritates me. They take an oath but it doesn't seem to work that way. Anyway, they had me in gown and my legs were freezing when this test was done.

I didn't think there was any one test for RSD.

Abasaki.....how did you react? I felt it to be cold but then again my legs were freezing from being in the "pretty" gown and waitng about 45 minutes for the doctor to come in the room.

Desi......IME doctor told me this.

Jo55....I read this after I posted the question, but it still doesn't seem like one test should give a doctor this opinion.

I was told by 4 doctors I have RSD, I was just wondering about this test and others reactions to it and what their doctors say about it.

Thanks.
Anyone else have input on this test???

[bassman]

Originally Posted by Jo55

I found this about it-
[Hendler Alcohol Drop and Swipe Test (7). In this test, a physician squeezes an alcohol swab so that a drop of alcohol lands on the patient's affected area. If the patient immediately withdraws the limb and complains of a burning pain, the physician has demonstrated thermal allodynia, i.e. a painful response to the cooling effects of a drop of alcohol on a limb. After two minutes, if there has been no response to the thermal test, a patient may begin to experience burning pain in the affected limb. This occurs as the fat soluble alcohol permeates the skin and begins to chemically irritate the hypersensitive C fibers, which conduct the message of pain. If the patient then experiences pain, this demonstrates chemical allodynia. Then, with the leftover alcohol swab, the physician gently strokes the affected area. If this produces pain, this clearly demonstrates mechanical allodynia. In order to establish the diagnosis of RSD (CRPS 1)]
http://209.85.173.104/search?q=cache...ient=firefox-a

Interesting

I can see that this might be one test in a battery of experiments to search for a dx of RSD, but if this is supposed to be definitive, I guess I haven't had it for all of these years.

I recently started a treatment for Rheumatoid Arthritis that is a self-injection of a type of immune system depressant. Because there are tons of warnings about carefully avoiding any exposure to infections, I wipe all sorts of alcohol on the injection site when I do it. While I does a feel uncomfortable (not soothing) I would not call it severe pain.

I can see the theory, but I don't believe it is a 100% "rule-in, rule-out" test.

Mike

[bassman]

Originally Posted by Summertime

Hi

I felt it to be cold but then again my legs were freezing from being in the "pretty" gown and waitng about 45 minutes for the doctor to come in the room.

Summertime --

I'm glad that you feel those gowns are pretty. They are particularly attractive on a man with hairy legs.

Mike

[Summertime]

Thanks for laugh bassman...I really needed that today.

Seriously you think they'd make those gowns a little warmer and cover a bit more.

Back to the swipe test...It confused me as did the other tests the other doctor did. (I posted in the other thread I started..titled How do you survive with this?)

[Jomar]

when i did the search for it - I found the info under that drs name {Nelson Hendler, M.D., M.S. } & then as I looked more I only found copies of the same thing. I didn't come up with any other references to it.

I didn't do any intensive search or look into medical publication sites.. so i don't know if it is a valid "test" or not.

But since you mention yours was from a IME exam anyone with work comp experiences will know that the IME are not there to help you or your claim.

Be sure to ask for a copy of his report, don't be surprised if reads like it was written for another patient...

You might also want to visit our workers compensation forum if you haven't found it yet.

[Abbie]

As I stated... "I had a doctor tell me that alcohol swipe test was a definitive test (in his opinion) to determine if someone truly has RSD or not."

This doctor is a very well respected specialist--Physiatrist. I didn't question why he had said this but he did.... more than once... Apparently got the reaction he was looking for... he said I reacted exactly as he expected for someone with RSD. He actually did this test each time I was in his office for the several visits...guess he was just making sure that I wasn't faking. Often time would have me looking at something else and drop alcohol on me. He got the same reaction each time.

I've been to numerous doctors---specialists knowledgable in RSD... they've all done this test on me with the same reaction from me.

My guess... and my guess only... there must be something to using the alcohol test to determine RSD or they wouldn't be doing it.


Abbie