RSD/CRPS

Posted by Anonymous @anon37227499, Nov 6, 2011

Does anyone have RSD/CRPS? Do you know if there's a current research study for this at the Mayo Clinic?

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Welcome @pfox,

I am 49 years old and have suffered with CRPS now for almost nine years now and unfortunately your daughters experience is very much
the way it goes for most of those that suffer from CRPS. There has been very little advancement in treatment for CRPS, especially considering
that it has been in existence since civil war times. At which time they thought it was all in the patients head. Many doctors still think that, despite the World Health Organization adding to the list of Rare Diseases in 2014. This was a significant win for CRPS patients as this then allowed for more money to be available for research!!

Currently you basically have three main things that you can try (beyond physical therapy, nerve blocks or surgical sympathectomy).

The first use to be the prescribing of opiods and/or narcotics for the pain itself. These often in conjunction with other medications meant to address the neuropathic pain such as Lyrica or Gabapentin.
Second is usually by way of SCSS (Spinal Cord Stimulation Surgery) This surgery places stimulating electrodes through a needle into the spine near the spinal cord, which provides a tingling sensation in the painful area. Electrodes may be placed temporarily for a few days in order to assess whether stimulation is likely to be helpful. Minor surgery is required to implant all the parts of the stimulator, including the battery, and electrodes under the skin. Once implanted, the stimulator can be turned on and off, and adjusted using an external controller.
Finally, the most recent (yet not that) is the use of Ketamin infusions. In which you go to hospital as in or outpatient and receive daily infusions of ketamin.
Both SCSS and ketamin infusions have not proven to be beyond 50% successful. Really SCSS is only a "distraction" not a cure.

As you mentioned with your daughter, in the case of medications which a lot of CRPS patients heavily rely on to help tolerate the excruciating pain just to get
through each day, this is now becoming more and more in jeopardy as the incidence of abuse in the country (including death) continues.
This will and most likely has already, resulted in more deaths in the CRPS community as a result of being denied their medications, which are the only
thing a lot of them have to help keep them from choosing death!
I myself have already been told by several doctors (when I was looking for a new GP) that they would take me off all of my pain medications immediately. This has resulted with me having to stay with a doctor that I am not that comfortable with. This because he knows that ALL of my medications were prescribed by a very knowledgeable pain doctor who happened to retire and left me without any referral.
Finally, my husband's company changed Insurance Companies and the new company wanted all of my medical records to ensure that I had tried all other
medical treatments available to me beyond the use of the narcotics and opiods. Of course I was able to do that no problem (who the hell who has CRPS has not looked everywhere to find some kind of relief beyond just taking pain meds?? Since my husband passed away last year, I only have one more year of his insurance coverage then I have to prescribe to our government for assistance (since I survive currently only on a meak disability payment) My medications cost more than my disability payment even before taxes!! I am hopeful that it will go the same as with the insurance company, although I know that they expect everyone to be prescribed opiods within a certain recommended range that was established by a community of medical doctors familiar with pain. I know I fall beyond that range! So, I am frankly scared of the day that they no longer provide me with the medications that I have been taking for a number of years. I am also afraid of the day that medications that I take no longer provide enough pain relief, especially since I am at the maximum dosages that are allowed to be prescribed!
So I a can fully empathize with you and your daughter as well as many other CRPS sufferers. I really do not know what is going to happen. As I am sure there are those CRPS sufferers that have already had to take their lives due to being denied their pain meds. Most likely they have just been lumped in with All of the other abusers or pain addicts!!
It is hard enough to try and continue to Want to live with CRPS. I have often found myself trying to justify continuing to live. Frankly, the only reason I am now is because of my dogs. Once they are gone (if I have not yet bust through the threshold of my pain meds before that, which I am not sure that I will be able to make it much longer to get beyond that) I will most likely go to. It really isn't worth the daily struggle in pain. Before anyone tries to judge, walk a mile in my shoes....ones that are embedded with razor blades and set on fire, while someone shoots darts into your legs and someone drags on your hips trying to drag you down. Then a lion claws at your thigh. Could you keep going with this happening day after day, year after year?

REPLY
@overwhelmed

Welcome @pfox,

I am 49 years old and have suffered with CRPS now for almost nine years now and unfortunately your daughters experience is very much
the way it goes for most of those that suffer from CRPS. There has been very little advancement in treatment for CRPS, especially considering
that it has been in existence since civil war times. At which time they thought it was all in the patients head. Many doctors still think that, despite the World Health Organization adding to the list of Rare Diseases in 2014. This was a significant win for CRPS patients as this then allowed for more money to be available for research!!

Currently you basically have three main things that you can try (beyond physical therapy, nerve blocks or surgical sympathectomy).

The first use to be the prescribing of opiods and/or narcotics for the pain itself. These often in conjunction with other medications meant to address the neuropathic pain such as Lyrica or Gabapentin.
Second is usually by way of SCSS (Spinal Cord Stimulation Surgery) This surgery places stimulating electrodes through a needle into the spine near the spinal cord, which provides a tingling sensation in the painful area. Electrodes may be placed temporarily for a few days in order to assess whether stimulation is likely to be helpful. Minor surgery is required to implant all the parts of the stimulator, including the battery, and electrodes under the skin. Once implanted, the stimulator can be turned on and off, and adjusted using an external controller.
Finally, the most recent (yet not that) is the use of Ketamin infusions. In which you go to hospital as in or outpatient and receive daily infusions of ketamin.
Both SCSS and ketamin infusions have not proven to be beyond 50% successful. Really SCSS is only a "distraction" not a cure.

As you mentioned with your daughter, in the case of medications which a lot of CRPS patients heavily rely on to help tolerate the excruciating pain just to get
through each day, this is now becoming more and more in jeopardy as the incidence of abuse in the country (including death) continues.
This will and most likely has already, resulted in more deaths in the CRPS community as a result of being denied their medications, which are the only
thing a lot of them have to help keep them from choosing death!
I myself have already been told by several doctors (when I was looking for a new GP) that they would take me off all of my pain medications immediately. This has resulted with me having to stay with a doctor that I am not that comfortable with. This because he knows that ALL of my medications were prescribed by a very knowledgeable pain doctor who happened to retire and left me without any referral.
Finally, my husband's company changed Insurance Companies and the new company wanted all of my medical records to ensure that I had tried all other
medical treatments available to me beyond the use of the narcotics and opiods. Of course I was able to do that no problem (who the hell who has CRPS has not looked everywhere to find some kind of relief beyond just taking pain meds?? Since my husband passed away last year, I only have one more year of his insurance coverage then I have to prescribe to our government for assistance (since I survive currently only on a meak disability payment) My medications cost more than my disability payment even before taxes!! I am hopeful that it will go the same as with the insurance company, although I know that they expect everyone to be prescribed opiods within a certain recommended range that was established by a community of medical doctors familiar with pain. I know I fall beyond that range! So, I am frankly scared of the day that they no longer provide me with the medications that I have been taking for a number of years. I am also afraid of the day that medications that I take no longer provide enough pain relief, especially since I am at the maximum dosages that are allowed to be prescribed!
So I a can fully empathize with you and your daughter as well as many other CRPS sufferers. I really do not know what is going to happen. As I am sure there are those CRPS sufferers that have already had to take their lives due to being denied their pain meds. Most likely they have just been lumped in with All of the other abusers or pain addicts!!
It is hard enough to try and continue to Want to live with CRPS. I have often found myself trying to justify continuing to live. Frankly, the only reason I am now is because of my dogs. Once they are gone (if I have not yet bust through the threshold of my pain meds before that, which I am not sure that I will be able to make it much longer to get beyond that) I will most likely go to. It really isn't worth the daily struggle in pain. Before anyone tries to judge, walk a mile in my shoes....ones that are embedded with razor blades and set on fire, while someone shoots darts into your legs and someone drags on your hips trying to drag you down. Then a lion claws at your thigh. Could you keep going with this happening day after day, year after year?

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@pfox (your daughter) and @overwhelmed, I am also on this journey. Took numerous doctors and many years to be diagnosed with CRPS. Mine is also going into different parts of my body--started with right ankle fracture, then the nerve pain moved to my left leg, up my right leg, into my left and right hands. My glucose levels, which I had controlled since being diagnosed as diabetic in 2008, started making no sense given my diet; my nutritionist is concerned that I have gastroparesis. Am having gastrointestinal issues as well. My right foot and calf feel numb, but also have intense pain. I take a smorgasbord of medications including oxy, gabapentin, cymbalta, etc. Tens didn't work nor ketamine lozenges or pain patches and from January 2016 to 2017 I participated in ketamine infusions every 4 to 5 weeks, yet my CRPS continued to spread and my pain is getting worse. My pain doctor has recommended that I go to a comprehensive pain center so that all my issues can be examined collectively and have an appointment with a doctor at the pain center at Beth Israel in Boston. My neurologist has said that my condition is only going to worsen over time. I am currently in a battle to ensure that the Board responsible for my disability retirement takes into consideration my CRPS, related pain issues and medications. They wanted to reject all that and only focus on my ankle (which was injured at work), but recently approved in a 7 to 5 vote to have me seen by 3 additional Independent Medical providers including a neurologist. I have already had numerous IMEs, but my hope is that through all this maybe the next person with CRPS that has to get approval will find it an easier path to follow. I am trying to make some meaning of the fact that I this disease and it helps keep me moving forward. CRPS can be a pretty lonely road--have lost friends that felt that I wasn't "trying hard enough" to heal. That hurts. Keep trying to find the joy that does exist in the world around us.

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Dear Overwhelmed and Janetdh - my heart breaks for you two and others that suffer from CRPS - those who can get a doctor to diagnose in early stages may have a better outcome with proper treatment - trying to be diagnosed with CRPS is a long road of process of elimination - along with many doctors today who think its all in the head... it's like a medical dark-ages for many. keep fighting and searching - there are those out there fighting... did you hear of the short movie /documentary of Trial By Fire - by Charles Mattocks - documents his mother's struggle - but maybe not but just encourages me that more notice is slowly being given to this horrible disease. My daughter is suffering from severe GERD - her gastro doctor found she has Esophageal Spasms that most likely caused by CRPS and she is taking s special blood pressure medicine that helps stop the muscles from spasms... she is showing some slow improvements with the GERD but not the CRPS - but please keep on fighting - and shouting out as CRPS is being recognized... and you know there are many out there suffering from it..... thank you for your input and insights.... keep strong!

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also - she has the TEMS in early stages - but great fear of surgery as that will only aggravate her CRPS - she has a PT that works on her knotted muscles from CRPS that does offer some relief - even if short lived - but never pain free. She has has received some ketamine cocktail type injections from her pain management doctor but not the IV ketamine yet... and to date no sucess... so please those with CRPS keep sharing.....

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Thanks for your support; my prayers for your daughter. Today I went to the local beach with my sister and with cane in hand, we ventured out into the water. It felt wonderful. Even with increased pain tonight, wouldn't change a minute of it.

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I am post-op, 17 months- CMC Arthroplasty. I was told that I have RSD. I have the hypersensitivity, on the back of my hand; still swelling; range of motion issues. What I don't have is the intense pain that everyone says I should have. My primary has told me she isn't sure if I can be/have a diagnosis of RSD, without the pain. My hand surgeon said that I do have RSD. I'll admit I have a high pain tolerance, but is there anyone out there that has this diagnosis but not much pain? I have burning sensation on the back of my hand; in the shower, it feels like needles on my hand, but, not the crazy constant pain. Thanks for any replies.

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@pattiwaggin

I am post-op, 17 months- CMC Arthroplasty. I was told that I have RSD. I have the hypersensitivity, on the back of my hand; still swelling; range of motion issues. What I don't have is the intense pain that everyone says I should have. My primary has told me she isn't sure if I can be/have a diagnosis of RSD, without the pain. My hand surgeon said that I do have RSD. I'll admit I have a high pain tolerance, but is there anyone out there that has this diagnosis but not much pain? I have burning sensation on the back of my hand; in the shower, it feels like needles on my hand, but, not the crazy constant pain. Thanks for any replies.

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Hello @toomuchyarn,

Thank you for posting your question about ketamine treatments for CRPS. You may notice that I combined your post with an existing discussion on RSD/CRPS. I did this because there are a few members that posted about ketamine treatments for CRPS. If you are replying by email notification, I suggest clicking on VIEW & REPLY so that you will be brought to the full discussion I moved your post to. From there, I suggest reading through some of the older posts and meeting members who experienced things similar to yourself.

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Greetings. While ketamine infusions didn't work for my CRPS, it did for other patients at the clinic providing them. I now have started meditation & biofeedback with psychiatric pain doctor at Beth Israel pain center and have found that it helps me manage better. I am also getting reike sessions, but it continues to be a journey. I hope the treatments help! Stay strong.

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@janetdh

Greetings. While ketamine infusions didn't work for my CRPS, it did for other patients at the clinic providing them. I now have started meditation & biofeedback with psychiatric pain doctor at Beth Israel pain center and have found that it helps me manage better. I am also getting reike sessions, but it continues to be a journey. I hope the treatments help! Stay strong.

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Thanks. It’s nice to hear from someone else with this miserable pain thing. Best wishes to you.

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@pattiwaggin

I am post-op, 17 months- CMC Arthroplasty. I was told that I have RSD. I have the hypersensitivity, on the back of my hand; still swelling; range of motion issues. What I don't have is the intense pain that everyone says I should have. My primary has told me she isn't sure if I can be/have a diagnosis of RSD, without the pain. My hand surgeon said that I do have RSD. I'll admit I have a high pain tolerance, but is there anyone out there that has this diagnosis but not much pain? I have burning sensation on the back of my hand; in the shower, it feels like needles on my hand, but, not the crazy constant pain. Thanks for any replies.

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Hi there @pattiwaggin , You certainly seem to have a lot of the symptoms of CRPS that is for sure, however the I believe the greatest symptom of CRPS is PAIN. I have read plenty on the subject and I have never come across anyone or any literature where pain was not part of CRPS. So to you I would say, count your lucky stars, you are special. However, knowing what I know, I would also say be careful
what you do not wish for........it may just come true.....and trust me, you will wish you didn`t!! While the symptoms you are experiencing are certainly uncomfortable and annoying to you, when you add the level of pain that CRPS presence itself with, it changes your world like you never thought possible.
In case you are not aware, McGILL Pain Index describes CRPS/ RSD, as the MOST painful form of chronic pain that exists today! That is also why some have given the diagnosis a nickname of "The Suicide Disease".
Even more so now that both Canada & the U.S. are on a mission to rid themselves of Narcotics & Opiods......Starting with patients!!!!
Doctors are being pressured to lower or take your patients all off of these types of drugs or they are in jeopardy of losing their licenses.. Anyone who really knows CRPS knows that, that is simply not that simple. and you are asking many of these patients to live with the most painful condition there is without providing known existing medications that would lessen it !! Additionally, this is without in many cases providing a substitute equal to that which is being taken away or a cure! Many patients with CRPS would rather die than be left in the kind of pain that CRPS leaves them in.
Doctor's are afraid of losing their licences, while patients are afraid of losing their lives!!! But who asked them anyway!!!
I believe while the origin of some of the street drugs may have been through patients or some so called doctors, it has come way further
than that now. The majority of the drugs are now shipped into the countries or made in people`s garages. But no one is processing that fact.
The governments are using guidelines established by pain specialists to help regular GPs know how much to prescribe for their patients. However as the specialists were afraid of, the governments are using the guidelines as ``law``
Finally, those patients that have been yanked off of their meds & do commit suicide without a note, but despite their families communicating (and sometimes even the patients themselves) telling the doctors what the results of that will be. Their deaths get lumped in with all of the other Opiod overdoses, even though that clearly was not the case. So no one is capturing the real impact that this initiative is having on actual patients needing pain meds ....FOR REAL!
Others are actually driven to the street drugs since they are given no choice when their medications are withdrawn!!
Again, no one is tracking or monitoring this!
I guess we are just another casualty on the War on Drugs!

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