The Pain Of RSD COMPLEX REGIONAL PAIN SYNDROME In an information age with technology that is staggering and allowing investigation of our universe thatis hardly imaginable, our society still struggles in areas far closer to home. One of these is in the treatment or management of  CHRONIC PAIN. Acute pain, on the other hand, is a simple somatic defense of transient nature. This is handled fairly well, but let it remain past a few weeks, and PAIN can were down even the most stoic of individuals. If the pain cycle remains rather simple, then sometimes treatment is effective and satisfactory. However, when the chronic pain becomes complicated, it becomes almost impossible to deal with for both patient and clinician.

Chronic Pain complicated by one or more of the following factors passes for RSD:

1. Involvement of the sympathetic nervous system creating a vicious cycle of vaso-constriction, inactivity, and perpetuation  of pain (Adrenergic)

2. Permanent central or peripheral nerve damage leading  to severe burning pain hyperesthesia, hyperpathia, and trophic changes.

3. Depression in the form of emotiohal exhaution and insomnia and at times secondary to the above.

4. All of the above yet without obvious injury.

RSD, the "pain that never stops", is not rare. although not nearly as common as headache or backache, the pain clinician is called upon to treat sympathetically mediated pain often enough. RSD is disabling and very unforgiving to the victim. Unless treated early it is almolst impossibleto return the victim to the workforce. Early diagnosis, extensive sympathetic blocks, physiotherapy and proper medicinal control are essential to prevent total debilitation.
 

Read Part II (Stages of RSD) in the nest issue of  The Standard.

Written by Marvin Lynn Faulkner, D.O.
Diplomate American Board of  Anesthesiology, Member of  American Academy of  Pain Medicne, Diplomate American Academy  of  Pain Management

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