Treatment for chronic regional pain syndrome - Reflex sympatetic dystrophy (RSD ) - Sudek’s atrophy
Management is difficult and the problem often very disabling.Early diagnosis,effective pain relief and general care of the patient are essential.
Physical therapy: Gradually increasing to use the program regarded as a painful limb or body part moving may help to restore range of motion and action.
Psychotherapy: CRPS often has profound psychological impact on people and their families. Those with CRPS may suffer from depression, anxiety or post-traumatic stress disorder, which increases the perception of pain and make rehabilitation more difficult.
Surgical sympathectomy: Surgical sympathectomy, a technology that destroys the nerves involved in CRPS, is controversial. Some experts believe it is unnecessary and makes CRPS worse, while others report a positive outcome.
Sympathectomy should be used only in patients whose pain is dramatically relieved (although temporarily), by a selective sympathetic blockade. spinal cord stimulation: to promote the placement of the electrodes adjacent to the spinal cord provides a pleasant tingling sensation in painful area. This technology can help many patients with their pain.
NSAIDs and corticosteroids are used in the early phase together with active exercise of the limb.Calcitonin may also help at this stage.If pain persists despite initial treatment ,a phentolamine test is used to test for evidence of sympathitically maintained pain (i.v infusion of up to 40mg with careful cardiac monitoring ) .If this is positive,a stellate ganglion block is used for upper limb and a sympathetic chain block for lower limb involvement.Guanethedine ( an alpha-blocking agent ) or lidocaine (lignocaine ) administered to the limb under tourniquet is also useful.Refferal to a pain management clinic is advisable.
The following measures can help reduce the risk of developing Complex Regional Pain Syndrome:
Use of vitamin C after a broken wrist. Studies have shown that people who use daily supplement of vitamin C after wrist fracture is a lower risk of complex regional pain syndrome, compared with those not taking vitamin C. Early mobilization after a stroke. Some studies show that people who get up and walk immediately after a stroke (early mobilization) to reduce the risk of complex regional pain syndrome.
The prognosis for Chronic Regional Pain Syndrome varies from person to person. spontaneous remission of symptoms occurs in some people. Others may have relentlessly pain and crippling, irreversible changes in spite of treatment. Some clinicians believe that early treatment is beneficial to limit the mess, but this belief has been justified by the evidence of clinical studies. Further research is needed to understand the aetiology of Chronic Regional Pain Syndrome, how it evolves, and the role of early treatment for better cure.
Management is difficult and the problem often very disabling.Early diagnosis,effective pain relief and general care of the patient are essential.
Physical therapy: Gradually increasing to use the program regarded as a painful limb or body part moving may help to restore range of motion and action.
Psychotherapy: CRPS often has profound psychological impact on people and their families. Those with CRPS may suffer from depression, anxiety or post-traumatic stress disorder, which increases the perception of pain and make rehabilitation more difficult.
Surgical sympathectomy: Surgical sympathectomy, a technology that destroys the nerves involved in CRPS, is controversial. Some experts believe it is unnecessary and makes CRPS worse, while others report a positive outcome.
Sympathectomy should be used only in patients whose pain is dramatically relieved (although temporarily), by a selective sympathetic blockade. spinal cord stimulation: to promote the placement of the electrodes adjacent to the spinal cord provides a pleasant tingling sensation in painful area. This technology can help many patients with their pain.
NSAIDs and corticosteroids are used in the early phase together with active exercise of the limb.Calcitonin may also help at this stage.If pain persists despite initial treatment ,a phentolamine test is used to test for evidence of sympathitically maintained pain (i.v infusion of up to 40mg with careful cardiac monitoring ) .If this is positive,a stellate ganglion block is used for upper limb and a sympathetic chain block for lower limb involvement.Guanethedine ( an alpha-blocking agent ) or lidocaine (lignocaine ) administered to the limb under tourniquet is also useful.Refferal to a pain management clinic is advisable.
The following measures can help reduce the risk of developing Complex Regional Pain Syndrome:
Use of vitamin C after a broken wrist. Studies have shown that people who use daily supplement of vitamin C after wrist fracture is a lower risk of complex regional pain syndrome, compared with those not taking vitamin C. Early mobilization after a stroke. Some studies show that people who get up and walk immediately after a stroke (early mobilization) to reduce the risk of complex regional pain syndrome.
The prognosis for Chronic Regional Pain Syndrome varies from person to person. spontaneous remission of symptoms occurs in some people. Others may have relentlessly pain and crippling, irreversible changes in spite of treatment. Some clinicians believe that early treatment is beneficial to limit the mess, but this belief has been justified by the evidence of clinical studies. Further research is needed to understand the aetiology of Chronic Regional Pain Syndrome, how it evolves, and the role of early treatment for better cure.
