Reflex Sympathetic Dystrophy (RSD/CRPS)

Home » Reflex Sympathetic Dystrophy (RSD/CRPS) » Treatment, Psychosocial Support

Pain Management Information for Patients
(Free Handout)

Treatment

The goals of treatment are to control pain and to maintain as much mobilization of the affected limb as possible. An individualized treatment plan is designed, which often combines physical therapy, medications, nerve blocks, and psychosocial support.

Medication

Medications are prescribed to control pain. The type of pain experienced by the patient determines the type of medication prescribed.

Constant pain caused by inflammation is treated with nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen, naproxen, indomethacin). Due to potenially severe gastrointestinal and cardiovascular side effects, NSAIDs should only be used as instructed.

Constant pain not caused by inflammation is treated with central acting agents such as tramadol (Ultram®).

Sharp pain and pain that disrupts sleep may be treated with antidepressants (e.g., amitriptyline, doxepin, nortriptyline, trazodone) or anticonvulsants (e.g., carbamazapine, pregabalin).

In select patients, generalized, severe pain that does not respond to other medications may be treated with opioids (e.g., propoxyphine, codeine, morphine).

Muscle cramps (spasms and dystonia) can be treated with clonazepam and baclofen.

Localized pain related to nerve injury may be treated with Capsaicin® cream, but its effectiveness has not been proven.

Medications that affect the sympathetic nervous system such as clonidine (Catapres®) can be useful in some cases.

Muscle stiffness may be treated with muscle relaxants such as

• Tizanidine (Zanaflex®)
• Baclofen
• Clonazepam (Klonopin®)

Physical Therapy

Physical therapy should include daily range of motion exercises. Patients should be advised to avoid activities that could accelerate osteoporosis or joint injury.

Nerve Block

Sympathetic nerve block interrupts the transmission of pain signals from a group of nerve cell bodies (called a ganglion). When treating an upper extremity, it is called a stellate ganglion block. A small needle is used to inject an alpha adrenergic antagonist alongside the windpipe. When treating a lower extremity the nerve block is performed in the lower (lumbar) spine.

The procedure, which is usually performed by a physician familiar with the technique, involves the insertion of a needle into the appropriate location and the injection of anesthesia into the ganglion. The effect is monitored over time.

Sympathectomy

Patients who have a good but temporary response to nerve block may be candidates for a surgical procedure called sympathectomy. The goal of this procedure, which involves cutting and sealing (cauterizing) a portion of the sympathetic nerve chain that runs down the spine, is suppression of sympathetic nervous system activity in the affected area. Performing sympathectomy for RSD is controversial and in some cases, the procedure worsens symptoms.

TENS Unit

A transcutaneous electrical nerve stimulation (TENS) unit may be used to treat the affected area. In some cases, spinal cord stimulators are implanted permanently to supply a low intensity impulse to a location in the spinal cord in an attempt to interrupt the pain signals that are being transmitted to the brain.

Psychosocial Support

RSD/CRPS patients often become depressed and anxious because of chronic pain and loss of physical ability. Counseling, support groups, and chronic pain center programs help patients learn coping strategies and provide emotional and psychological support.

Reflex Sympathetic Dystrophy (RSD/CRPS), Treatment, Psychosocial Support reprinted with permission from neurologychannel.com
© 1998-2008 Healthcommunities.com, Inc. All Rights Reserved.

Reflex Sympathetic Dystrophy (RSD/CRPS) Resources

	Join Our RSD Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
Advertising Disclaimer To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer