RSD and CRPS

FAQs on RSD and CRPS Treatment in Oklahoma

 

Complex regional pain syndrome (CRPS) is characterized as a chronic pain that occurs in one extremity. This condition, often called reflex sympathetic dystrophy (RSD), is often the result of central or peripheral nervous system dysfunction.

 

How common is complex regional pain syndrome?

 

In a recent study, researchers at the May Clinic evaluated the incidence of CRPS as part of the Rochester Epidemiology Project. They found that the incident rate of the disease was 5.5 per 100,000 person years at risk, with 20 people affected per 100,000 population. Females were affected more than men, with the female to male ratio being 4:1. The median age at CRPS onset was 46 years, and the upper extremities were affected twice as often as the lower ones.

 

What are the symptoms of complex regional pain syndrome?

 

CRPS patients with this condition may experience pain disproportional to the original tissue damage or injury. Symptoms are usually perceived as being within the affected body part, but can radiate outward over time. Symptoms include:

 

  • Skin discoloration
  • Increased sensitivity to pressure or cold
  • Sweating
  • Consistent pain for 3 or more months
  • Swelling
  • Increased joint immobility or inflexibility
  • Muscular spasms
  • Altered nail/hair growth
  • Rapid changes from feeling cold to hot

 

What causes complex regional pain syndrome?

 

The exact cause of complex regional pain syndrome is not completely understood. It is thought to be related to nerve damage. Certain nerves associated with pain signal transmission continue to send signals, even though healing of injury has occurred. The damage is the result of adverse events that result in severe injury. Damage to the small nerve fibers of the peripheral nervous system that interact with blood vessels lead to inflammation. This results in a perception of excessive pain. Injuries known to lead to CRPS include:

 

  • Blunt-force trauma
  • Joint injury
  • Limb fractures
  • Infection associated with subsequent tissue damage
  • Soft tissue injury
  • Complications arising from medical/surgical procedures

 

How is CRPS treated?

 

The doctor will use a combination of measures to treat CRPS?

 

  • Rehabilitation/physical therapy – An exercise program will keep a painful limb or body part moving to improve blood flow. In addition, exercises help the limb’s flexibility, function, and strength. For daily tasks, occupational therapy is used.

 

  • Medications – Several drugs are used to treat CRPS, such as bisphosphonates, anti-inflammatory agents, corticosteroids (treat swelling and inflammation), botulinum toxin injections, local anesthetic creams (lidocaine), anticonvulsants (gabapentin and pregabalin), antidepressants, and opioids.

 

  • Sympathetic nerve block – This involves injecting an anesthetic onto the spine to directly block the activity of sympathetic nerves and to improve blood flow.

 

  • Stem cell therapy – In a recent case study, a patient with CRPS underwent stem cell grafting. At 2-weeks follow-up, trophic skin changes showed signs of lessening. In addition, at 30 days, the patient was able to walk with adaptive devices. At her 6-weeks visit, allodynia, vasomotor instability, and trophic skin changes all improved.

 

How can stem cells help treat complex regional pain syndrome?

 

There are many research studies that support the use of stem cells in orthopedic conditions. In clinical practice today, stem cells have shown to improve joint space narrowing, and peripheral nerve regeneration has been reported. In a case study of a patient with stage 3 RSD who had chronic tropic skin changes and pain, stem cells were implanted into the calf. Within weeks, allodynia and trophic changes dramatically improved. The author concludes that stem cell grafting is a viable alternative to treating RSD.

 

Resources

Sandroni P, Benrud-Larson LM, McClelland RL, & Low PA (2003). Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study. Pain, 103(1-2), 199-207.

Schwartz RG (2010). Stem Cells For The Treatment of Complex Regional Pain Syndrome (CRPS)/ Reflex Sympathetic Dystrophy (RSD): a case study. Pan Am J Med Thermol 1(2): 89-92.

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