How is reflex sympathetic dystrophy treated

Reflex sympathetic dystrophy typically develops after an injury, surgery, stroke or heart attack. The cause of complex regional pain syndrome isn't clearly understood. Symptoms of reflex sympathetic dystrophy or complex regional pain syndrome typically affect the arms and legs and may include:. Pain management specialists begin diagnoses of reflex sympathetic dystrophy by reviewing your medical history and performing a physical exam.

Tests may also be conducted to confirm diagnosis, including:. Early diagnosis and treatment of reflex sympathetic dystrophy or complex regional pain syndrome improves the chances of successful treatment. If not treated stiffness and loss of use of the affected limb may develop. Treatment focuses on pain relief and can include sympathetic nerve blocks and spinal cord stimulation. Options for treating reflex sympathetic dystrophy or complex regional pain syndrome may include:.

The Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore, Maryland, provides leading edge interventional pain treatment for conditions including spinal stenosis , herniated disk , facet arthropathy , osteoarthritis , reflex sympathetic dystrophy , post-herpetic neuralgia , peripheral neuropathy and cancer pain. Treatment goals during the advanced stages are aimed at symptom relief and improving function.

Your doctor can prescribe medications to help ease your symptoms. A combination of medications may be used including pain relievers, antidepressants, certain blood pressure medications, and steroids.

Injected pain relieving medications, spinal cord stimulation, and implanted medication delivery pumps may provide pain relief for longer periods of time. You may be referred to rehabilitation, including aquatic therapy. Participating in rehabilitation will help ease symptoms and improve function in your limb. Your therapists may use modalities, such as application of hot and cold treatments or a transcutaneous electrical stimulation TENS unit. Desensitization techniques may be helpful for hypersensitivity.

Additionally, aquatic therapy can provide a warm and supportive environment for you to safely exercise. In many cases treated with injections, therapy should immediately follow an injection, to take advantage of the relief the injection may provide.

Surgery is rarely indicated for CRPS. For those cases in which the syndrome is caused by nerve injury or compression, surgery to resolve the problem can help relieve symptoms.

CRPS that is treated in the early stages has the best outlook. If treated early, CRPS can go into an inactive state and function is optimized.

If CRPS is not diagnosed and treated promptly, irreversible changes can occur in the involved extremity. There is no known prevention for CRPS. Prompt treatment may prevent the progression of symptoms. This information is intended for educational and informational purposes only. This can deprive underlying muscles and deeper tissues of oxygen and nutrients, which can cause muscle weakness and joint pain.

When skin blood vessels over-constrict clamp down , the skin becomes cold, white, gray, or bluish. CRPS develops only in the limbs because circulation is constrained there. Arterial blood pumped down to the hands and feet must fight gravity to return upwards in the veins to the heart. C-fiber damage can impede this, permitting blood fluids to remain in the limb where the swelling then further blocks return blood flow.

Slowed circulation impedes delivery of oxygen and nutrients needed for healing and sometimes causes spreading of cellular injury. Breaking the cycle by reducing limb swelling and restoring circulation is often the key that permits recovery to begin. Poor nerve health.

Conditions such as diabetes or exposure to nerve toxins can leave the nerves less resilient. A key to CRPS recovery is improving general nerve health by removing or improving conditions that slow nerve regrowth.

Immune system involvement. The C-fiber nerve cells also communicate with immune cells to help us heal from injury. Excess or prolonged nerve signaling can dysregulate immune cells in the affected limb, as does CRPS-associated poor circulation.

Some people with CRPS have elevated local levels of inflammatory chemicals called cytokines that contribute to the redness, swelling, and warmth in the CRPS-affected limb. CRPS is more common in individuals with other inflammatory and autoimmune conditions such as asthma.

Some individuals with CRPS may have abnormal antibodies that promote an immune attack on small fibers. Rare family clusters of CRPS have been reported. Familial CRPS may be more severe with earlier onset, greater dystonia, and the involvement of more than one limb. Since CRPS generally improves over time, diagnosis is easiest early in the disorder and should not be delayed. Rehabilitation and physical therapy.

This is the single most important treatment for CRPS. Keeping the painful limb or body part moving improves blood flow and lessens circulatory symptoms, as well as maintains flexibility, strength, and function. Rehabilitating the affected limb helps prevent or reverse secondary spinal cord and brain changes associated with disuse and chronic pain. Occupational therapy can help people learn new ways to become active and return to work and daily tasks.

People with severe CRPS often develop secondary psychological problems including depression, situational anxiety, and sometimes post-traumatic stress disorder. These heighten pain perception, further reduce activity and brain function, and make it hard for patients to seek medical care and engage in rehabilitation and recovery. Graded motor imagery.

Certain interventions and medications may help relieve and treat symptoms. You may also seek physical therapy and psychotherapy to reduce the effects of RSD. You may find that your condition improves dramatically with treatment, but some people have to learn how to manage their symptoms.

A variety of medications are available for RSD, ranging from over-the-counter pain relievers and topical creams to prescription drugs from your doctor.

These medications include:. Physical therapy may help you rehabilitate the affected limb. This type of therapy will ensure that you continue to move the limb to retain its abilities.

It also improves your blood flow and reduces symptoms related to circulation problems. Regular physical therapy may be needed to reduce symptoms. Seeing a health professional for psychotherapy may also be necessary with RSD. You may develop a psychological condition from the chronic pain associated with the condition.

Psychotherapy will help you manage your mental health. You may also find that complementary alternative therapies like acupuncture or relaxation methods work for treating your RSD.

While some research discusses the prevention of RSD for specific cases, there is no conclusive evidence that a person can avoid RSD completely.

Read more: What to expect when recovering from a stroke ». RSD can result in a variety of outcomes. You may find that early intervention and treatment minimizes your symptoms and allows you to return to life as usual. On the other hand, your symptoms may get worse and may not be diagnosed in a timely fashion.

Quadriparesis refers to weakness in all four limbs.