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What I would do if I was diagnosed with
Reflex Sympathetic Dystrophy? Come to Caring Medical for Prolotherapy! The first pain syndrome I encountered that really got me interested in a career in pain medicine was reflex sympathetic dystrophy, also known as RSD. I don’t want to sound disrespectful for folks who suffer with this condition, I am just saying that one reason I went into the chronic pain field was that I loved studying about RSD. I amassed quite a bit of medical literature on the topic of RSD when I was first studying pain. What I felt from the getgo was that modern medicine was not getting at the root as to what was perpetuating the disease. It was clear to me even as a Physical Medicine and Rehabilitation resident that immobility was one of the reasons RSD occurred. Almost every case I saw in residency presented with the patient experiencing quite a bit of time after the initial injury with the limb, foot, or elbow immobilized. In my opinion, it is a bad idea to immobilize part of the body, except after a fracture. Immobilization is about the worst thing an injured person can do. Providing movement and circulation to the extremity is the only chance to heal the area. Even when a joint is swollen, we recommend moving it. Heat is also recommended instead of ice, as heat increases circulation to the area, which will mean that healing substances are then sent to the injured area. Immobility and ice, and for that matter elevation, decrease healing substances to the area. This means a greater chance of non-healing and a greater chance for RSD to develop. RSD is a condition where the patient experiences continuous pain in an extremity with sympathetic hyperactivity. RSD is typically progressive. The pain is typically described as burning or aching which is exacerbated by touch, emotional upset, or active/passive movement. The pain is tremendous. Yes, even the feel of the bed sheet on a foot with RSD can be excruciating. Because the person doesn’t move the limb much, the sympathetic hyperactivity can even cause abnormal blood flow to the skin, soft tissues, and bones of the joint. Eventually this may result in osteoarthritis of the limb and the person can develops a permanently frozen or contracted limb. Recently I had a severely pinched nerve in my neck. If I wasn’t a pain doctor and knew what to do, I definitely would have not moved my involved arm because moving the right arm caused sharp pains to go down my arm. I suspect I would have developed RSD with that injury. So what would I do now if I had that diagnosis? Number one, I would get as quickly to Caring Medical in Oak Park, IL as I could. An RSD client needs a doctor passionate about the condition and one who has had success in treating it and getting people back to normal living. This involves not only Prolotherapy, but a comprehensive natural medicine approach. Plus, being a Physiastrist or Physical Medicine and Rehabilitation Specialist, I can recommend exercises for the patient to do that will help in treating this disorder. Why is RSD perpetuated? Many times RSD occurs after a trauma or fracture of a bone. Typical starting areas involve the hand or foot. I surmised once I learned the technique of Prolotherapy that it was an unhealed ligament injury that was perpetuating the RSD. People with RSD who have had trauma to the foot or hand, often had a fracture. The fracture is treated with immobility. This is good for the fracture, but bad for the ligaments that were injured during the trauma. Once the fracture is healed, the orthopedist tells you that you are fine now and sends the person to physical therapy. When the pain increases, the physical therapist and the orthopedist believe that this is normal after a fracture because of the stiffness of being in a cast. What they don’t realize is that the person has a ligament injury and what they need is Prolotherapy. You can guess the rest of the scenario. The person is put through a host of treatments that are bad for ligament healing. This includes more immobility, elevation, ice, and anti-inflammatory medications. They really should be called anti-healing medications. Yes, this includes motrin, ibuprofen, Aleve, Naproxen, and the rest. They have their place, but not in ligament injuries. Eventually the person sees a chronic pain specialist that diagnoses the RSD. That is the good news. The bad news is that they don’t have great treatments for it. The treatments are more anti-healing therapies like morphine, codeine, vicodin, or other strong pain relievers. There has to be a better way. The good news is - there is! What we do at Caring Medical is to do a comprehensive natural evaluation. The person with RSD can do a lot to get themselves healthy. The mainstay treatment involves natural hormone replacement. The hormone tests typically show that the person with chronic pain has poor healing ability because of low anabolic hormone levels. Treatments may include DHEA, human growth hormone (HGH), and possibly Testosterone. Hauser Diet Typing is done which will show problems with carbohydrate metabolism and/or blood pH. These are balanced with changes in the patient’s diet. Food allergy testing is also done and allergenic foods are eliminated from the diet which decreases systemic inflammation, which decreases pain to some degree. A sleep program and Xyrem for sleep (if needed) is typically prescribed. Getting a good night’s sleep helps tremendously. What next? Exercises are done to tolerance. Putting pressure on the area is typically ok to do once the extremity has healed some from the Prolotherapy. Prolotherapy is given to all the painful areas in the extremity. Typically conscious sedation is given including Demerol and/or versed. This makes the Prolotherapy injections much more tolerable for the person with RSD. If they don’t want to get conscious sedation then pain medications can be taken about 30 minutes before the visit. Pain control after Prolotherapy is with Ultram, muscle relaxers (yes valium and its cousins are ok) and Tylenol. Generally one year’s worth of care is necessary to get the person back to normal function. Back they come. Back to smiling. Back to laughter. Back to being the son or daughter they want to be. Back to being the spouse they used to be. Most of us could be better at that one. Yes, even yours truly! Most importantly, back to having hope. Hope that the world is a great place to live and that we all can make a difference in making it better. Hope that there is a cure out there for RSD and one of the pieces of the puzzle is Prolotherapy. |
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information only and not a self-help guide NOR AS SPECIFIC HEALTH
RECOMMENDATIONS. Never alter or change your health management or begin
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