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Reflex Sympathetic Dystrophy is a relatively
rare but devastatingly painful disease. It has recently
been more appropriately renamed Complex Regional Pain
Syndrome. The exact mechanism of this pain syndrome is
unknown, but there is thought to be some sort of short
circuit between the sympathetic nervous system and the
sensory nervous system. When this occurs, people often
experience a severe burning discomfort, usually limited
to one extremity. It tends to migrate from distal to proximal
extremities, meaning it may move from the hand to the
shoulder or from the foot to the thigh. Complex Regional
Pain Syndrome can be associated with a profound loss of
joint range of motion in the affected extremity, as well
as hyperasthesia, which is extreme pain even to a light
touch with the affected extremity, as well as a fluctuation
between hot and cold feelings and color changes involving
the affected extremity.
Treatment for Complex Regional Pain Syndrome involves
blocking the sympathetic nervous outflow to the affected
extremity. When this pain problem involves the arms, the
appropriate treatment is to perform a Stellate Ganglion
Block. A Stellate Ganglion Block is delivered in the neck
just lateral to the trachea. When the affected extremity
is a leg, the appropriate treatment is blockage of the
sympathetic nervous system at the level of the lumbar
spine. This is called a Lumbar Sympathetic Block. These
procedures require precise placement of needles and often
require the use of fluoroscopic guidance to confirm accurate
needle placement. It is not uncommon to require a series
of nerve blocks in order to control the level of discomfort
a patient experiences. |
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