Although the success for treating RSD / CRPS varies from patient to patient and from medical provider to medical provider, there is belief in the medical community that long-term treatment can lessen the effects of this disease. It is also well recognized that treatment should be started as soon as possible after the diagnosis of RSD / CRPS has been made. In general, the following treatment options may be considered for the management of patients with RSD / CRPS:
- Physical Therapy
Physical therapy is considered an important initial treatment for RSD and may be used alone or in combination with other treatment modalities. The purpose of physical therapy is to attempt to restore function to the limb, alleviate pain, strengthen muscles, and reduce swelling. This is typically done by utilizing motion exercises to improve circulation and range of motion.
- Drug Therapy
Although the type of drug and course of treatment will vary depending upon the patient and their level of pain, drug therapy is a critical part of any RSD treatment. This may involve the use of analgesics (pain medications), anticonvulsants (muscle relaxants), corticisteroids, opioids, and antidepressants. There may also be severe cases that would require intrathecal drug delivery. This necessitates surgical implantation of an intraphecal pump that is utilized to administer medications directly into the spinal fluid.
- Sympathetic Nerve Blocks
A sympathetic nerve block is a procedure usually performed by a pain management specialist (anesthesiologist) that involves injecting a pain relieving drug into the ganglion (group of nerves) to block sympathetically maintained pain. These blocks are typically done in timed intervals and may be continued until pain diminishes.
If the pain is not sympathetically-maintained pain, then the sympathetic nerve blocks may not provide any relief. However, if the pain is sympathetically driven then the nerve block should provide at least temporary relief.
A sympathectomy is a procedure that is intended to sever the ganglion and prevent sympathetic nerve pain.
This RSD treatment option meets with both strong support and opposition in the medical community. The procedure carries more risks than other procedures and should generally be considered as a last resort treatment option for the management of RSD / CRPS.
Patients should seek multiple opinions before undergoing this procedure and should fully weigh the risks and benefits.
- Neurostimulation Systems
Many patients have had success or increased tolerance to CRPS / RSD pain through the use of neurostimulation systems. These medical devices are designed to be easy to implant, simple to program, and are highly flexible providing patients with increased programming options.
These devices are indicated when the patient has chronic or intractable pain of the trunk and/or limbs. These devices are, however, contraindicated for patients with pacemakers or for patients who are unable to operate the system or fail to achieve any effective pain relief during the trial simulation of the system.
Your treating physician should be consulted about warnings and precautions that apply when using a device of this type.