Hi Everyone.

I can't find any posts related to RSD. I am in so much pain, swollen hand/arm, burning pain.

Is anyone else dealing with this?

I haven't been diagnosed with RSD, but I see a pain specialist tomorrow and I don't know what to expect. Can he diagnose RSD? My IM doctor thought that is what I have in addition to TOS.

Does anyone here have RSD and if so, what are your symptoms?

Thank you.

Several people on this thread have or potentially have RSD. There is another forum for RSD under the "Health Conditions M-Z". I think this is the link: http://neurotalk.psychcentral.com/forumdisplay.php?f=21

And if you have trouble finding any of your posts - just click on your user name and then click on " find more posts by dealingwithtos"

and they'll all come up in a listing - then you can find the ones you are looking for.

Hi,

There are several of us here with TOS and RSD, it's not uncommon to have both. A pain management Dr SHOULD be familiar with RSD, but it depends on their main area of practice. If they mainly give blocks, they may not know that much about it (that won't stop them from acting like experts though).
If they are affiliated with a university or teaching hospital, they should be well-informed. If they are at a pain manangement clinic, it really depends on their training, experience and philosophy.

Are they a neurologist or anesthesiologist, are they accredited as a Pain Management physician, do they keep up-to-date with the medical journals and research? These are important to know. An anesthesiologist who is an accredited Pain Management or a neurologist should be knowledgeable about RSD, but they should also attend conference sessions and read literature to stay up-to-date as so much important work has come out in the RSD/CRPS area in the last 10 - 15 years.

There are a variety of sx and not everyone will have all of them, and some you will have at different times in the progression of the RSD. But for dx, here are the most recent tables being used:

TABLE 1. IASP (ORLANDO) DIAGNOSTIC CRITERIA FOR COMPLEX REGIONAL PAIN SYNDROME (adopted 1996)
1) The presence of an initiating noxious event, or a cause of immobilization
2) Continuing pain, allodynia, or hyperalgesia with which the pain is disproportionate to any inciting event
3) Evidence at some time of edema, changes in skin blood flow, or abnormal sudomotor activity in the region of pain
4) This diagnosis is excluded by the existence of conditions that would otherwise account for the degree of pain and dysfunction

Type I: without evidence of major nerve damage
Type II: with evidence of major nerve damage

This second one is proposed, not in use, but I include it because the Orlando one has been criticized as not being specific enough; the previous ones included criteria much like this one does - onlythey didn't allow for reports at all, if the Dr didn't SEE skin color changes or temp changes, etc in his office, it didn't count - or maybe it just never happened!

TABLE 3. REVISED CRPS CRITERIA PROPOSED BY THE BUDAPEST CONSENSUS GROUP
General Features of the Syndrome:
CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked)
regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other
lesion. The pain is regional (not in a specific nerve territory or dermatome) and usually has a distal predominance of
abnormal sensory, motor, sudomotor, vasomotor and/or trophic findings. The syndrome shows variable progression
over time.
There are two versions of the proposed diagnostic criteria: a clinical version meant to maximize diagnostic sensitivity
with adequate specificity, and a research version meant to more equally balance optimal sensitivity and specificity.
These proposed criteria are described in Table 3A and Table 3B, respectively.
TABLE 3A. CLINICAL DIAGNOSTIC CRITERIA FOR CRPS
1) Continuing pain, which is disproportionate to any inciting event
2) Must report at least one symptom in three of the four following categories:
Sensory: Reports of hyperesthesia and/or allodynia
Vasomotor: Reports of temperature asymmetry and/or skin color changes and/or skin color asymmetry
Sudomotor/Edema: Reports of edema and/or sweating changes and/or sweating asymmetry
Motor/Trophic: Reports of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia)
and/or trophic changes (hair, nail, skin)
3) Must display at least one sign* at time of evaluation in two or more of the following categories:
Sensory: Evidence of hyperalgesia (to pinprick) and/or allodynia (to light touch and/or deep somatic pressure
and/or joint movement)
Vasomotor: Evidence of temperature asymmetry and/or skin color changes and/or asymmetry
Sudomotor/Edema: Evidence of edema and/or sweating changes and/or sweating asymmetry
Motor/Trophic: Evidence of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia)
and/or trophic changes (hair, nail, skin)
4) There is no other diagnosis that better explains the signs and symptoms
*A sign is counted only if it is observed at time of diagnosis.

Good Luck tomorrow!

beth