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Wednesday, February 15, 2012


I went to a new pain Dr today, was not throilled about going because the pain Dr I had seen previousley locally preformed a procedure on my back that left me with tingling in my lefgs and feet, swollen ankles, purplish tint to my feet and legs, and numbness in my legs and feet. But my Ortho Dr wanted me to sdee him and with getting disability from work if I want to keep my monthly check I had to go.
I went the PA(Physicians Assistant) I first saw checked out my lower body, asked me questions had me walk, and asked me to do some thing sI couln't do becase of my right hip pain. Soon she had the Dr come in. He looked at my xrays, MRI, bone scan and all the other test results I had brought with me and says I think you have RSD, But I won't know until we do a procedure(injection) into your spine. Which really has me concerned going into my spine. He explained to me what RSD is somewhat, and explained with the use of a spine model what the procedure would entail. When it was done I scheduled the procedure which is done in his office for Monday 2/20/12
We will see what happens.
Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome (CRPS), is a chronic progressive neurological condition that affects skin, muscles, joints, and bones. The syndrome usually develops in an injured limb, such as a broken leg. However, many cases of RSD involve only a minor, seemingly inconsequential injury, such as a sprain. And in some cases, no precipitating event can be identified.

Pain may begin in one area or limb and then spread to other limbs. RSD/CRPS is characterized by various degrees of burning pain, excessive sweating, swelling, and extreme sensitivity to touch. Symptoms of RSD/CRPS may recede for years and then reappear with a new injury.
TypesTwo types of RSD/CRPS have been defined:

Type 1 - without nerve injury
Type 2 (formerly called causalgia) - with nerve injury
Both types express the same signs and symptoms
Conditions associated with the onset of RSD/CRPS include:
Trauma (e.g., bone fracture, gunshot and shrapnel wounds) Spinal cord disorders Cerebral lesions Heart disease, heart attack Hemiplegia (paralysis on one side of the body) Infection Radiation therapy Repetitive motion disorder (e.g., carpal tunnel syndrome) Surgery In 10% to 20% of cases, no direct cause can be found. Injury that precedes the onset of RSD/CRPS may or may not be significant.

RSD Signs and Symptoms

The symptoms of RSD/CRPS may progress in three stages acute, dystrophic, and atrophic although this notion is subject to debate.

Acute: burning pain, swelling, increased sensitivity to touch, increased hair and nail growth in the affected region, joint pain, color and temperature changes; first 1-3 months

Dystrophic: constant pain and swelling, limb feels cool and looks bluish, muscle stiffness and atrophy (wasting of the muscles), early osteoporosis (bone loss), 3-6 months

Atrophic: cool and shiny skin, increased muscle stiffness and weakness, symptoms  may spread to another limb

RSD/CRPS can be difficult to diagnose and often requires excluding other conditions that produce similar symptoms. A thorough history and neurological examination is of utmost importance. During the exam, the clinician may notice that the response to mild sensory stimuli produces severe pain.

Physical examination involves observing the skin color and temperature, swelling, and vascular reactivity; overgrown and grooved nails; swollen and stiff joints; muscle weakness and atrophy (wasting).

Other conditions are ruled out with appropriate testing that may include MRI studies, a full laboratory panel, EMG/NCV (electrophysiological studies of the nerves and muscles), and a test known as a thermogram, which uses an infrared video camera to measure the emission of heat from the affected limb.
More to come

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