Reflex Sympathetic Dystrophy (RSD)What is Reflex Sympathetic Dystrophy (RSD) ?

Reflex Sympathetic Dystrophy (RSD) is a chronic pain disorder associated with sensitivity to light touch swelling, skin color and temperature changes, weakness, abnormal sweating, muscle atrophy, and subsequent depression.

Who does RSD typically affect?

RSD can follow a simple trauma (fall or sprain) a break or fracture (especially wrist and ankle) a sharp force injury (such as a knife or bullet wound), heart problems, infections, surgery, RSI/CTS, spinal injuries/disorders, or major trauma.  But the precipitating cause is not always known.  The original injury may happen weeks, months, or even years before the proper diagnosis is made, which contributes to this problem.  RSD strikes both men and women, but typically about 75% of patients are women.  It strikes victims from 1 to 101, although about 65% of patients contract the disease in their thirties and/or forties.

What are the most common symptoms of RSD?

There are four Main Symptoms/Criteria for a diagnosis of CRPS/RSDS: constant chronic burning pain, inflammation, spasms-in blood vessels and muscles of the extremities, and insomnia/emotional disturbance (including limbic system changes). Not all four symptoms are required for a diagnosis but most patients do have at least three out of the four at any one time.

What are the traditional treatments for RSD?

Most people who suffer from RSD only receive pain management. This means being prescribed a multitude of narcotics, and antidepressants. Then RSD patients must start on a schedule of stellate ganglion /sympathetic blocks. With the exception of a few who respond initially, this expensive therapy is repeated weekly or monthly for the rest of the RSD patient’s life. When CRPS/RSDS sufferers fail to respond to these blocks, the patient is referred for morphine pump implants or spinal stimulators and requires ongoing physician management on a monthly basis to make the proper adjustments.

Why is RSD amenable to oxygen therapy?

Hyperbaric oxygenation decreases inflammation and edema while increasing blood flow to the starved limbs and nerves that are damaged by the course of the disease. This in turn reduces fibrous tissue formation. Dr. Ken Stoller states, ?HBOT seems to break the vicious self sustaining cycle of reflex sympathetic dystrophy, because normalization of local tissue oxygen tension, pH and water interstitial content stops abnormal sensory nerve stimulation and efferent vasomotor activity.?

What benefits can I expect from oxygen therapy for RSD?

Most RSD sufferers report a full night?s sleep after a few treatments of HBOT along with a decreased need for narcotics.  After a series of treatments, there is a reported noticeable improvement in thinking and diminished depression. The swelling of the effected arm or leg associated with RSD diminishes, and they are able to start physical therapy with marked improvement in muscle strength. Many people afflicted with RSD have then been able to return to a happier and more productive life, frequently returning to their prior occupation.

Since every patient is different it is hard to predict the result in each individual case.  However, we know from 50 years of experience that HBOT is safe and will not make the patient worse.  The usual course of oxygen therapy is once daily, five days a week (M-F) for eight weeks.  If a significant response is noted after 40 HBOT treatments, then additional treatments may be helpful.

Effectiveness of hyperbaric oxygen therapy in the treatment of complex regional pain syndrome. J Int Med Res. 2004 May-Jun;32(3):258-62. RSD Kiralp MZ, Yildiz S, Vural D, Keskin I, Ay H, Dursun H. Department of Physical Therapy and Rehabilitation, Gulhane Military Medical Academy,Haydarpasa Training Hospital, Istanbul, Turkey. mkiralp@hotmail.com In this double-blind, randomized, placebo-controlled study we aimed to assess the effectiveness of hyperbaric oxygen (HBO) therapy for treating patients with complex regional pain syndrome(CRPS). Of the 71 patients, 37 were allocated to the HBO group and 34 to the control (normal air) group. Both groups received 15 therapy sessions in a hyperbaric chamber. Pain, oedema and range of motion (ROM) of the wrist were evaluated before treatment, after the 15th treatment session and on day 45. In the HBO group there was a significant decrease in pain and oedema and a significant increase in the ROM of the wrist. When we compared the two groups, the HBO group had significantly better results with the exception of wrist extension. In conclusion, HBO is an effective and well-tolerated method for decreasing pain and oedema and increasing the ROM in patients with CRPS. PMID: 15174218 [PubMed – in process]  

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Disclaimer: The information provided does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made.

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