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Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome Fact Sheet
RSDS fact sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS).Category Health Conditions and Diseases Chronic pain syndromes What is reflex sympathetic dystrophy/complex regional pain syndrome Other studiesto overcome chronic pain syndromes are discussed in the pamphlet pain Hope
http://www.ninds.nih.gov/health_and_medical/pubs/rsds_fact_sheet.htm

Extractions: Request free mailed brochure What is reflex sympathetic dystrophy/complex regional pain syndrome? What are the symptoms of RSD/CRPS? What causes RSD/CRPS? Who gets it? ... Is help available? RSD/CRPS is a chronic condition characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling, and extreme sensitivity to touch. The syndrome is a nerve disorder that occurs at the site of an injury (most often to the arms or legs). It occurs especially after injuries from high-velocity impacts such as those from bullets or shrapnel. However, it may occur without apparent injury. The condition called "causalgia" was first documented in the 19th century by physicians concerned about pain that Civil War veterans continued to experience after their wounds had healed. Doctors often called it "hot pain," after its primary symptom. Over the years, the syndrome was classified as one of the peripheral neuropathies, and later, as a chronic pain syndrome. Currently, there are two types of CRPS that are differentiated-type I and type II. Both types share the same basic set of symptoms, but have one distinct difference: type I (previously referred to as RSD) describes cases in which there is no nerve injury, while type II (formerly called causalgia) refers to cases in which a distinct nerve injury, for example from a gunshot wound, has occurred
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An in depth report about complex regional pain syndrome authored by Donna M Pittmann, MD and Miles Category Health Conditions and Diseases complex regional pain syndrome type II (causalgia) upper extremity, 354.4; lower ofchronic pain, descriptions of chronic pain syndromes and definitions of
http://www.aafp.org/afp/971200ap/pittman.html

Extractions: Articles Departments Patient Information The term "complex regional pain syndrome" encompasses causalgia and reflex sympathetic dystrophy. Symptoms of burning pain with autonomic and tissue changes begin shortly after an injury, usually to a distal extremity. The diagnosis is based on the history and the clinical findings. No confirmatory tests are available, although plain radiographs or a three-phase bone scan may be helpful in diagnosing some cases. Aggressive treatment, which may include sympathetic blockade, medications, physical therapy and psychotherapy, is essential for a favorable outcome. Despite treatment, many patients are left with varying degrees of chronic pain and disability. Complex regional pain syndrome is a perplexing condition that can occur following injury, usually to an extremity. Patients with this syndrome experience burning pain along with autonomic and tissue changes in the region of the injury. This group of symptoms has also been referred to as "reflex sympathetic dystrophy" or, in the case of a known nerve injury, "causalgia." To clarify the confusing terminology, the International Association for the Study of Pain in 1993 designated "complex regional pain syndrome" to correspond with reflex sympathetic dystrophy (type I) and causalgia (type II).
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Indeed, in theory patients with complex regional pain syndrome may or may not harbor sympathetically maintained pain, defined as all pain syndromes that can
http://www.aafp.org/afp/971200ap/editoria.html

Extractions: Articles Departments Patient Information Reflex Sympathetic Dystrophy: Fact and Fiction As discussed in the article by Pittman and Belgrade, the term "reflex sympathetic dystrophy" has been used for most of this century to describe complaints of pain associated with subjective motor or sensory symptoms and erratic objective vascular changes in color and temperature of the symptomatic body part, often with enigmatic onset and chronic deterioration. Such complaints undoubtedly exist. Although the term is descriptive, it implies that the condition is a scientifically established medical entity, with known and discrete pathophysiology. However, this concept has recently been challenged. By description, reflex sympathetic dystrophy is a neurologic complex. The term has connotations of neurophysiology (reflex), of the autonomic system (sympathetic) and of tissue decay (dystrophy), and yet a noted neurologist remarked that the condition is "neither reflex nor sympathetic nor dystrophy." Until recently, a vast majority of physicians believed that reflex sympathetic dystrophy is a specific disease in which the pain and the "autonomic" dysfunction are determined by the sympathetic system. Criteria have relied on (1) the common presence of local vasomotor imbalance in the absence of primary vascular disease, and (2) the subjective relief of pain in response to sympathetic nerve blocks. Sporadic attempts have been made to explain the sensory phenomena that often accompany the pain and vasomotor disturbance but without success.
International Pelvic Pain Society
Is Chronic Pelvic pain a form of complex regional pain Syndrome? ; Voiding Dysfunctionand Chronic Pelvic pain syndromes Neuromodulation A New Therapy.
http://www.pelvicpain.org/resources_physician.asp

Extractions: History and Physical Form Physician Resources Approach to the Patient With Chronic Pelvic Pain Chronic Pelvic Pain: Scope of the Problem Chronic Pelvic Pain: Diagnosis and Management A Comprehensive Review of Chronic Pelvic Pain The Multidisciplinary Approach ... Approaches to Treating Chronic Pelvic Pain
Complex Regional Pain Syndrome
under the umbrella term complex regional pain Syndrome (1 the clinical findings includeregional pain, sensory changes of chronic pain syndromes and definitions
http://www.rsdsa-ca.org/complex_regional_pain_syndrome.htm

Extractions: Since it's first clinical description in 1864 when Doctor Mitchell published a classic description of causalgia in a paper entitled, "Gunshot Wounds a nd Other Injuries of Nerves" , Reflex Sympathetic Dystrohpy ( RSD ) has been called many different names such as Causalgia, Suddeck's Atrophy, Raynauds and most recently - Complex Regional Pain Syndrome. In an attempt to define a taxonomy that more accurately describes conditions that fall under the umbrella term Complex Regional Pain Syndrome the International Association for the Study of Pain (IASP) Committee on Taxonomy recently revised it's previous description and published those clinical features consistently found in these conditions. To satisfy a diagnosis of CRPS type I (RSD) , the clinical findings include regional pain, sensory changes, allodynia, abnormalities of temperature, abnormal sudomotor activity, edema, and an abnormal skin color that occur after a noxious event. CRPS type II (Causalgia) includes all foregoing features in addition to a peripheral nerve lesion.
Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS)
1996. StantonHicks M, Baron R, et al. Consensus Report complex regionalpain syndromes Guidelines for therapy. Clin J pain 1998 14 155-66.
http://www.rsdfoundation.org/cpg_references.html
THE MERCK MANUAL, Sec. 14, Ch. 167, Pain
Neuropathic pain syndromes, except for the complex regional pain syndrome,usually do not respond to sympathetic blockade. These
http://www.merck.com/pubs/mmanual/section14/chapter167/167d.htm

Extractions: This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 14. Neurologic Disorders Chapter 167. Pain Topics [General] Acute Postoperative Pain Cancer Pain Neuropathic Pain ... Psychogenic Pain Syndromes Neuropathic Pain Chronic pain can develop after injury to any level of the nervous system, peripheral or central. A variety of specific syndromes have been identified. Their pathogenesis is obscure, and their incidence and prevalence are unknown but appear to be low relative to the injuries that precede them, except for root avulsion injuries and phantom limb pain. The sustaining mechanisms of two broad categories of neuropathic pain appear to involve reorganization of central somatosensory processing: deafferentation pain (due to partial or complete interruption of peripheral or central afferent neural activity) and sympathetically maintained pain (dependent on efferent sympathetic activity). Both are complex, and although presumably related pathogenetically, they differ substantially. For example, a thalamic lesion that causes pain without autonomic or trophic changes and that is unresponsive to manipulation of the sympathetic nervous system is clearly distinct from a lesion that produces reflex sympathetic dystrophy, in which all of these characteristics may be present. Deafferentation pain syndromes include postherpetic neuralgia, central pain (pain after CNS injury), and phantom pain. Phantom pain is experienced in the region of the missing body part after any type of amputation; phantom limb pain is the best characterized type.
COMPLEX REGIONAL PAIN SYNDROME PRESENTING AS MOVEMENT DISORDER IN
regional pain syndrome (CRPS) is a complex condition difficult to diagnose and evenmore difficult to treat. The term encompasses a wide variety of syndromes
http://med.ege.edu.tr/norolbil/2000/NBD11800.html
Pain Multimedia Library
These modules present a basic overview of common pain syndromes. The animations,presented complex regional pain Syndrome. Previously known as
http://www.stoppain.org/multimedia/
Complex Regional Pain Syndrome | David J. BenEliyahu DC, DACBSP
I. complex regional pain Syndrome, Type II. psychotherapy. Reference. Tollisonand Satterthwaite. Sympathetic pain syndromes RSD and causalgia.
http://www.chiroweb.com/archives/14/21/09.html

Extractions: MassageToday.com David J. BenEliyahu DC, DACBSP Complex regional pain syndrome (CRPS) is the new title that has been advocated for reflex sympathetic dystrophy syndrome and causalgia by the International Association for the Study of Pain. A new taxonomy has been suggested because not all cases have "sympathetic maintained pain" (SMP), and not all cases demonstrated dystrophy. These conditions usually follow a precipitating injury that does not heal as expected, and is often accompanied by unrelenting pain that is out of proportion to the initial injury. There have been two categories of CRPS described: Type I, and Type II. Sympathetic maintained pain (SMP) may or may not be found in association with CRPS, and is characterized by pain that is maintained by sympathetic innervation or circulating catecholamines. SMP can be abolished by sympatholytic agents. Complex Regional Pain Syndrome, Type I
Complex Regional Pain Syndrome Type 1
Many other syndromes similar to CRPS have pain and swelling but Table 4 PossibleDifferential Diagnosis for complex regional pain Syndrome Type 1 (Schiller
http://www.curtin.edu.au/curtin/dept/physio/podiatry/encyclopedia/crps1/

Extractions: Complex Regional Pain Syndrome Type 1 (CRPS) Author: Julie Hodder Back to Encyclopedia Index Complex Regional Pain Syndrome (CRPS) is reported to be one of the most difficult and painful conditions that the podiatrist is likely to treat (Perlman, 1992). It is a syndrome with a primary symptom of constant, burning pain (Wyngarden and Bleyaert, 1991). Other symptoms include hyperesthesia, swelling, hyperhidrosis and trophic changes in the skin and bone of the affected extremity (Schwartzman and McLellan, 1987). There are a number of events that can lead to CRPS with trauma being a significant factor (McNerney, 1991). The resultant pain is usually greater than the initial injury (Perlman, 1992) and there are a number of other aetiological factors associated with the syndrome development.
Krafchick Law Firm - Complex Regional Pain Syndrome
complex regional pain Syndrome (or CRPS) often develops after a simple nerve injurythat evolves Like other chronic pain syndromes, CRPS can become debilitating
http://www.krafchick.com/complex.html

Extractions: The symptoms associated with CRPS may change as the syndrome progresses. For example, the patient may initially complain of a swollen limb, the next month the patient may experience coldness in limbs or even complain of a seemingly disassociated symptom such as hair loss or discolored skin. The hallmark symptom is a burning pain that usually develops within a few months of the original injury. The symptoms may spread from one limb to another or from one side of the body to another. CRPS can cross from one limb to another across the body, and even change symptoms entirely as the syndrome progresses.
Review Article
complex regional pain syndrome, or reflex sympathetic dystrophy, is a complex formof somatic (unrelated to the sympathetic) system pain syndromes.
http://www.rsdcrps.com/reviewarticle.html

Extractions: CLICK HERE For Comments - Questions - Feel free to contact: Jim O'Donnell Review Article An excerpt from a review article from PAIN DIGEST - 1999 Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy Syndrome): Diagnosis and Therapy The records of 824 complex regional pain syndrome (CRPS) patients referred in January 1991 to January 1996 are reviewed in this article, and the diagnostic and therapeutic approaches are compared with studies reported in the medical literature. At least two followup visits were required to enable a patient to be included in the study. Problems of terminology and over and underdiagnosis are discussed. Background Complex regional pain syndrome, or reflex sympathetic dystrophy, is a complex form of neuropathic pain associated with hyperpathia, neurovascular instability, neuroinflammation, and limbic system dysfunction. It is triggered by stimulation of neurovascular thermoreceptor C fibers sensitized to norepinephrine. This afferent sensory impulse leads to CRPS. The syndrome involves extremities, head, back, shoulder, and breast, as well as viscera. Complex regional pain syndrome has a long list of etiologies, including trauma. The trauma is usually minor. Major trauma is more likely to stimulate somatic (nonsympathetic) nerves, which tend to overshadow the sympathetic type of pain, reducing the likelihood of development of CRPS. Certain traumatic events are more common originators of CRPS: repetitive stress injury; an unexpected injury such as stepping off a curb or missing a step; and an injury to the dorsum of the hand or foot are some frequent causes.
Reflex Sympathetic Dystrophy Also Known As CRPS (Complex Regional Pain Syndrome)
RSD is one of the classic syndromes that can produce such pain. in diagnosing RSDled to the official name change to complex regional pain Syndrome, but it is
http://www.painstudy.ru/matls/pneuro/crps.htm

Extractions: Reflex Sympathetic Dystrophy also known as CRPS (Complex Regional Pain Syndrome) SAPF When I was a senior medical student (more years ago than I care to admit), I was working the emergency ward at San Francisco General Hospital. A huge man walked in wearing a leather jacket, a beard to his belt, and a motorcycle helmet, (all 6 feet, 500 lbs of him - at least that's how I remember him). Anyway, all the nurses scampered out of the way to let him pass, and my heart jumped into my throat when he turned into the room I was working. Nervously, I asked him what the trouble was. He raised his hand as if he was about to strike me, and I got ready to jump out of the way. He pointed to his elbow and said gruffly, "Doc, I have an 'owee' right here." I smiled, calmed myself, and examined his arm which had been injured mildly in a fall a month earlier. The elbow and forearm were swollen and red and he would yelp with pain even when I touched the arm lightly. The neurologic examination revealed normal motor and sensory functions of the nerves. In those days, we were taught that pain would affect specific nerves, and that any pain beyond those specific nerves was considered psychological. We would treat what we could physically, and ship them off to counseling. I had doubts that counseling would help this patient so I gave him some pain medicine and scheduled him for evaluations in the neurology and orthopedic clinics. At that time, I, like most doctors, had never even heard of RSD. It was not taught in medical school.
Bonicas Management Of Pain (3rd Ed.)
components of neuropathic pain, including complex regional pain syndrome (reflex andmusculoskeletal pains, including myofascial pain syndromes and fibromyalgia
http://www.ampainsoc.org/pub/bulletin/may01/reso1.htm

Extractions: Reviewed by Ronald Pawl, MD Encyclopedic is the only word that describes, albeit barely adequately, this monumental work. The editors have successfully managed to include everything one could want or need to know about pain of any sort, from acute to chronic, from nociception to perception, in any part of the human body. In the first edition of the book, John Bonica indicated that a main intent of the text is to provide the general physician with a resource for determining methods of treatment for pain. This edition goes much further than that; it provides information valuable to specialists in every field of medicine, including those practicing pain medicine. The text is divided into five parts, arranged in a quite logical order for which the editors are to be commended. The first consists of basic elements, followed by a part on evaluation of the patient in pain. The third part covers generalized pain syndromes, the fourth is about regional pain problems, and the last analyzes treatment strategies. Part I, Basic Considerations of Pain, which includes the usual and thorough discussions of anatomy, basic and applied, and physiology also has chapters on historical aspects; basic psychological aspects; and gender, cultural, and environmental aspects of pain. There also are chapters on general considerations of acute and chronic pain and a general overview of multidisciplinary pain programs.
Chronic Pain Syndromes
The following list of pain problems and syndromes is not totally inclusive Back toTop complex regional pain Syndrome (CRPS) complex regional pain Syndrome
http://www.cipm.com/syndrome.html

Extractions: The most common and best understood type of pain is acute pain. Acute pain will result when tissue is injured by trauma, surgery, illness, or infection. This type of pain is generally understood and expected. It is typically sharp, shooting, aching, or burning, and it decreases as the tissue heals and the body recovers. This is pain that is "talking to you" and telling you that something is wrong. The sudden onset of pain in the neck or back can occur after an injury or can appear without a known problem. If pain is only in the tissues around the spine and does not radiate into the limb, it is less likely to involve pressure on the nerve roots. If pain is radiating into the limb, then this is more likely to involve pressure on the nerve. The etiology could be strain or tearing of the supporting tissues with intense muscle spasm, a herniation of the disc between the vertebrae, or a fracture of the bony structure of the spine. Initial care will include rest, pain medications, muscle relaxants, and possible epidural steroid injections, with trigger point injections for muscle spasm. The early use of physical therapy is important in many cases.
Complex Regional Pain Syndrome: Understanding Reflex...
complex regional pain Syndrome. descending control is to restore autonomic balanceand reduce pain. Arnis B, Grundberg MD, Reagan D. Compression syndromes in RSD
http://www.acupuncturetoday.com/archives2000/nov/11priebe.html

Extractions: MassageToday.com Ted Priebe, LAc, OMD, QME Complex Regional Pain Syndrome: Understanding Reflex Sympathetic Dystrophy (RSD) The first clinical description of reflex sympathetic dystrophy occurred in 1863, when Dr. S.W. Mitchell described a burning pain called causalgia in Gunshot Wounds and Other Injuries of Nerves Reflex sympathetic dystrophy is now known as a neurogenic disease with a multisymptom medical condition that affects one or more extremities. RSD was officially recognized and given an ICD-9 code (337.2) in 1993. It is described as an intense, severe burning pain, usually with swelling, color changes to the skin, and intense sensitivity to touch and temperature. Generally, it is caused by a slight injury; repetitive motion injury; surgery; venipuncture; laceration; burns; degenerative joint disease; compression due to casting; infection; and myocardial infarction. Many patients may have accompanying neuromas; peripheral neuropathies; temporal mandibular joint pain; nerve entrapments such as carpal tunnel or thoracic outlet syndrome; and peripheral nerve compression. RSD will affect up to five percent of these patients. Complex Regional Pain Syndrome Stage one of RSD diagnosis usually consists of sympathetically maintained pain in one region, and includes sensory changes, allodynia, hyperpathia, edema, and sudomotor and vasomotor changes.
American RSDHope Group
of chronic pain description of chronic pain syndromes and definition anestheticsinjected into sympathetic ganglia of complex regional pain syndrome patients.
http://www.rsdhope.org/ShowPage.asp?PAGE_ID=33&PGCT_ID=2361
Paper On Underappreciated Pain Syndromes By Mary Alice McLarty, Attorney
The task becomes more arduous when our clients have underappreciated pain syndromessuch as complex regional pain Syndrome (also known as Reflex Sympathetic
http://www.maryalice.com/Documents/UnderAppreciated.html

Extractions: I. Introduction As trial lawyers, we have all been faced with the challenge of convincing a jury of the extent of our clients' injuries and with the problems of persuading those jurors about the pain our clients have suffered. The task becomes more arduous when our clients have underappreciated pain syndromes such as Complex Regional Pain Syndrome (also known as Reflex Sympathetic Dystrophy), myofacial pain, fibromyalgia, whiplash, temporal mandible joint pain syndrome, and so on. Contesting these pain syndromes has become a "defense du jour" as the insurance lawyers try to undermine our clients' damages. The physical aspects of myofacial pain and fibromyalgia have been prepared by other speakers in this program, therefore, this writer will illustrate the preparation of an underappreciated pain syndrome by spotlighting Reflex Sympathetic Dystrophy. Similar methods of presenting your damage case can be tailored to the individual pain syndrome of your case. II. Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome)
SAM - Supporting Children In Pain (SKIP) - UK - Support Group
dedicated to raising awareness of complex regional pain Syndrome (commonly site providesinformation about Neuropathic pain and it's associated syndromes.
http://shsskip.swan.ac.uk/home.htm

Extractions: Also Chi l dren with Arterio-venous Malformations RSD (CRPS) Alliance - United Kingdom RSD (CRPS) Alliance UK - is an informal community of websites and support groups dedicated to raising awareness of Complex Regional Pain Syndrome (commonly known as RSD) and to supporting RSD patients and carers. Whilst each group retains its individual character and style, the community as a whole seeks to maintain responsible and professional standards in the promotion of its aims. SKIP is proud to be part of this community.

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