Joseph and Martin,
 
Please see www.ptlitup.com | Archive & Search | RSD: Diagnosis & Treatment (it's free).
 
By chance a very effective and safe therapy has been discovered (i.v. bisphosphonates -- mind that the needle should be placed in the contralateral arm). Together with low-dose oral steroids, this should just about cure the patient.
 
Sympathetic blocks have on several occasions been found to be ineffective.
 
R.,
Frank 
 
 
----- Oorspronkelijk bericht -----
Van: [log in to unmask] href="mailto:[log in to unmask]">Beatus, Joseph
Aan: [log in to unmask] href="mailto:[log in to unmask]">[log in to unmask]
Verzonden: vrijdag 6 februari 2004 15:19
Onderwerp: Re: R.S.D.

HI. A couple of points.  RSD nomenclature has been modified to signify (in general) vascular and neural pain syndromes. Classified as Complex Pain Syndrome I (vascular) II (neurogenic, the old causalgia), respectively. So now what to do. Always a difficult problem. From our experience: sympathetic blocks, if truly vascular, and/or neurontin; pain meds and/or block before therapy. GENTLE, GENTLE, GENTLE!

 For therapist in general, see to it that patients are referred to you with the cast on. Odd changes (a cluster of S& S) will alert you so that:movement of digits to start early, cast cut, changed but pressure has to be relieved. For physical therapy per se- Gentle joint mob and movemet, and all other modalities that may think of .NO pain. Gentle, heat AND NO COLD. Joe (For more peruse the hand journals)

 

-----Original Message-----
From: - for physiotherapists in education and practice [mailto:[log in to unmask]] On Behalf Of Martin Adams
Sent: Friday, February 06, 2004 3:32 AM
To: [log in to unmask]
Subject: Re: R.S.D.

 

These cases can respond very well to Connective Tissue Massage, a technique described by Maria Ebner , first described in her book "CTM theory & therapeutic application" in 1962 , published by Robert Krieger - I have a copy of the 1980 reprint !  However, the usual problem - evidence is descriptive, non-randomised, non-blinded but anyone who has done or received it will tell you that it has a profound effect on the sympathetic nervous system.

 

 Nikki Adams MCSP SRP Grad Dip Phys BSc (Hons) Chartered Physiotherapist and Certified Practitioner in Neuro-Linguistic Programming    [log in to unmask]

 

----- Original Message -----

From: [log in to unmask] href="mailto:[log in to unmask]">mary obrien

To: [log in to unmask] href="mailto:[log in to unmask]">[log in to unmask]

Sent: Thursday, February 05, 2004 10:12 PM

Subject: Spam Alert: R.S.D.

 

Advise needed on the treatment of Reflex Sympathetic Dystrophy following a fracture to the wrist. Pain from elbow to the metacarpal phalangeal joints.  The most severe pain around the ulna.  Gross muscle dystropy of the extensors and the interossei.  Pt referred to OT following removal of plaster this increased the pain with consequent loss of function.  Your help would be appreciated.

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