Belle,
You are probably familiar with many aspects of this disease, so
please bear with me if parts of my answer are already known to you.
RSD, reflex sympathetic dystrophy, is currently being called CRPS
(CRPS I , often called RSD, caused by an injury other than a nerve
injury and CRPS II- still called causalgia and caused by a nerve
injury, for complex regional pain syndrome. )CRPS is more common in
women and young children.Common causes are traumas such as burns,
fractures, wounds, surgery, sprains, strokes, herpes infection,
injections, heart attacks, malignancies (cancers) and even tooth
extraction, to list a few.
http://www.rsdsa-ca.org/What%20is%20RSD.html
Symptoms of RSD/CRPS include pain, edema (swelling) joint stiffness,
muscle pain, and skin changes. Diagnosing RDS/CRPS is difficult and
often overlooked. When all of the symptoms are present, diagnosis may
be obvious. A complete history and neurological examination is
imperative. Response to mild sensory stimuli produces severe pain.
There may be changes in the hair, nails, joints, and muscles-- joints
may be swollen and stiff, and the muscles may be weak and atrophied
(wasted). Diagnostic tools used are MRI, bone scans, blood tests and
thermograms(an infrared camera used to measure heat from affected
extremities)
RSD’s first documented appearance was in the 1600s, by Amboise Pire,
King Charles IX’s surgeon. King Charles suffered burning pain
following a nerve injury after a bloodletting.
http://www.emedicine.com/pmr/topic123.htm
In 1864, a Doctor Weir Mitchell coined “Causalgia” as a name for this
syndrome, and it is often still referred to by this name. (By the way,
medical researchers, doctors, and scientists really don’t change
medical nomenclature to confuse us….as more information is gathered
about a certain disease, or groups of diseases, clinical taxonomy can
change. Names of diseases/syndromes/conditions therefore change to
reflect the latest descriptive category)
http://www.rsdsa-ca.org/complex_regional_pain_syndrome.htm
Acording to an article by Manish Singh, MD, on the emedicine
website, there is limited information in the US about the epidemiology
of CRPS as it is often misdiagnosed. “Some sources report, the
incidence of causalgia (CRPS II) following injury to a peripheral
nerve is 1-5%. The incidence of RSD (CRPS I) is 1-2% after various
fractures and 2-5% after peripheral nerve injury.”
http://www.emedicine.com/pmr/topic123.htm
1) The progressive nature of the disease:
The chronological progression of this disease is divided into three
stages. Stage 1, the acute stage, presents with pain, swelling and a
warm feeling over the painful areas. The person may feel very
sensitive to touch, especially to the feeling of clothing on the skin.
This stage usually lasts about 3 months.Osteoporosis can begin, from
insufficient skeleto-muscular movement and demineralization of bone.
Stage 2, the dystrophic stage, presents with the person having cold
skin with noticeable skin changes, ranging from damp to dry skin. The
skin can atrophy(waste away) and break down. Osteoporosis worsens.
This stage can last 9 months. Stage 3, the atrophic stage is presents
with muscle wasting and joint contractures (where muscles or scar
tissue shortens or contracts, causing a deformity) . 80% of patients
with RSD that is diagnosed within 1 year of injury will improve
significantly. However, 50% of patients with untreated symptoms
lasting more than 1 year will have profound residual impairment.
Osteoporosis can become severe, and “claw hand” can develop from
contractures.
http://www.emedicine.com/orthoped/topic280.htm
http://www.emedicine.com/med/topic2936.htm
2) Osteoporosis, especially of the hands:
As mentioned in the progression part of my answer, osteoporosis
develops over the course of the three stages, due to demineralization
of the bone(primarily calcium and phosphorus loss). Hands and wrists
are more vulnerable to osteoporosis because this area is constantly
regenerating itself , breaking down ,reabsorbing old bone, and
regenerating new bone . As if osteoporosis were not sufficiently
unpleasant, contractures set in, causing the above mentioned
“claw-hand”, which is painful in itself.The form osteoporosis takes in
RSD is called Sudeck atrophy, which some use as another name for
RSD/CRPS.
Some palliative measures for the pain and range of motion are massage,
heat, Velcro straps, and splints. At times painful nerves are cut
(sympathectomy) or injected with anti-inflammatory drugs.
http://www.emedicine.com/med/topic2936.htm (Bottom of section 6)
http://www.medmedia.com/05/122.htm
http://www.nlm.nih.gov/medlineplus/ency/article/003169.htm
3) Depression/suicide
Many people who suffer from RSD do experience depression, and even
suicidal thoughts from the pain, both physical and emotional. As with
any very painful condition, a good pain management regimen is of
critical importance. RSD patients may feel as if they are not taken
seriously, since RSD associated pain may not be perceived by others as
real pain. (sufferers know the contrary)
http://www.neurologychannel.com/rsd/
http://www.seaa.com/pain_chronic.htm#Behavioral%20changes%20caused%20by%20pain.
Suicidal thoughts seem to be associated with the first two years of
being diagnosed. Possibly once a person accepts the terms they must
live with, and learns management techniques, the depression and
suicidal thoughts subside, especially with proper medication. The
following site, RDSHope has an article written by Keith Orsini, with
his thoughts on the impact of RSD on one’s emotions.
http://www.rsdhope.org/ShowPage.asp?PAGE_ID=1&PGCT_ID=8
http://www.rsdhope.org/ShowPage.asp?PAGE_ID=1&PGCT_ID=2242
http://www.rsdhope.org/ShowPage.asp?PAGE_ID=1&PGCT_ID=2243
Since anti-depressants are often used in the treatment of RSD for
irritability and insomnia, some patients may never develop depression.
Often several medications will need to be tried before finding the one
that works best for an individual patient.
http://www.rsdcrps.com/4problems.html
http://www.rsdrx.com/rsdpuz4.0/PUZ_118.HTM
I could find no statistics on numbers of RSD related suicides or
depression however-just vague references, whose links are above.
Extra information:
An excellent, informative site, with many links to further
information, well presented, with suggested diagnostic studies.
http://www.medmedia.com/oa4/38.htm
and
http://www.rsdsa-ca.org/What%20is%20RSD.html
Diseases mistaken for RSD :
http://www.rsdrx.com/Differential%20Diagnosis.htm
Osteoporosis:
http://www.womenshealthchannel.com/osteoporosis/index.shtml
Pain management
http://www.mayoclinic.com/findinformation/conditioncenters/invoke.cfm?objectid=BBE945FF-7750-4DA4-AAE822D242A60CFB
http://www.sppm.org/Reflex%20Sympathetic%20Dystrophy.htm
http://www.tlcrehab.net/pain_management.htm
RSD in Children:
http://www.americansocietyforrsd-crps.org/societypages/childrentrouble.html
A page of links about RSD
http://copewithrsd.virtualave.net/rsdpage.html
To download a copy of Clinical Practice Guidelines in RSD
http://www.rsds.org/cpgeng.htm
Finally, I’d like to caution you about finding reliable health
information on the Internet. The following site can help you determine
whether medical information online is reliable.
http://www.quackwatch.com
If I have not made my answer sufficiently clear and understandable,
please ask for a clarification of your question.
Best of luck
-crabcakes-ga
search strategy;
RDS
RDS + osteoporosis
suicide + RDS
suicide + CRPS
depression + RDS
depression + CRPS
pain management |
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