Tuesday, June 3, 2014

Complex Regional Pain Syndrome and Acupuncture

Complex Regional Pain Syndrome – CRPS – also known as Reflex Sympathetic Dystrophy (RSD), is a chronic progressive condition triggered by nerve injury and characterized by severe pain, inflammation, swelling and changes in the skin affecting arms, legs, hands or feet. Experts have yet to discover the cause of CRPS but know that injury or surgery may initiate the onset (Type 2), even though in some cases no previous or very minor injury occurred (Type 1). [i]

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Upper extremity Complex Regional Pain Syndrome

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Lower extremity Complex Regional Pain Syndrome

The condition is extremely painful, debilitating and difficult to treat as there is currently no cure and most treatment revolves around alleviating the symptoms and pain management.

CRPS has historically gone by many names, including sympathetic trophoneurosis, minor causalgia, Sudeck atrophy, algoneurodystrophy, acute bone atrophy, peripheral trophoneurosis, painful osteoporosis, sympathalgia, and its most well-known former name—Reflex Sympathetic Dystrophy (RSD). This term (RSD) remains part of the vocabulary of many treating physicians. RSD describes a symptom however, and not a disease state. CRPS, as established by the International Association for the Study of Pain (IASP) in 1993, is now the accepted term.[ii]

The pain is severe and continuous often described as a combination of burning and electrical shocks. Part or all of a limb may be affected, become hypersensitive and if touched, bumped on, or exposed to temperature changes the pain can be excruciating. There may eventually be muscle atrophy (wasting) in the affected limb due to non-use triggered by increased pain.

It is hopeful that modern medical science will discover both a preventative and a cure for this extremely painful and damaging syndrome. In the past, experts often attributed symptoms to a psychological trigger (psychosomatic – “all in the mind”), but this has been disproved as more recent research shows that distinct physical changes occur in the nervous system. Although the psychological support aspect is often included in the treatment of CRPS sufferers, this is now seen as the result of the trauma of constant pain and resulting debility of CRPS, rather than as the instigator.[iii]

In recent years, treating physicians are increasingly advocating the alternative therapy of acupuncture in conjunction with conventional medicines and procedures to alleviate the syndrome’s debilitating effects and improve quality of life.[iv]

Although acupuncture cannot cure CRPS, the good news about the use of acupuncture for the treatment of a condition as the perplexing and intractable as CRPS is that acupuncture treats what is happening to and in the body, and does not rely on the treatment of the cause of that occurrence. Even if the exact etiology of the syndrome is still unknown, acupuncture can treat the body’s response, helping afflicted patients to find some relief from the distressing symptoms of this debilitating syndrome.[v]

References:

  1. http://www.medicalnewstoday.com/articles/184338.php
  2. Coughlin, Michael J., Charles L. Saltzman, and Robert B. Anderson. Mann’s Surgery of the Foot and Ankle, 2013, Chapter 14, “Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy),”pp.705-717 https://www.inkling.com/read/coughlin-manns-surgery-the-foot-ankle-9th/chapter-14/complex-regional-pain-syndrome
  3. http://www.nhs.uk/conditions/complex-regional-pain-syndrome/Pages/Introduction.aspx
  4. Sprague, Marie and Chang, J. C. Integrative Approach Focusing on Acupuncture in the Treatment of Chronic Complex Regional Pain Syndrome, The Journal of Alternative and Complementary Medicine Volume 17, Number 1, 2011, pp. 67–70 http://www.rsds.org/pdfsall/acm-2010.pdf
  5. http://rsdguide.com/2013/09/09/acupuncture-treatment-crps/
    http://voices.yahoo.com/article/31094/acupuncture-rsd-crps-35991.html