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RSD and the Sympathetic Nervous System

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RSD and the Sympathetic Nervous System Empty RSD and Endorphins

Post  byrd45 Mon Jan 05, 2009 7:33 pm

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From: byrd45 (Original Message) Sent: 10/4/2005 5:43 PM
From: <NOBR>byrd45</NOBR> (Original Message) Sent: 9/22/2005 11:21 AM
Hi Everybody,

This week I thought it would be interesting to discuss Endorphins and RSD. I have been told that Endorphins are affected because of the RSD but really didn't understand what my doctor was talking about until I read some of this information. Now I understand why he keeps telling me how much walking and water exercise are helpful to people with RSD and why he insists that Narcotics really don't help with the pain as much as other medications. The following information was really helpful to me and I hope you enjoy reading it as well:




Definition:

natural painkiller: a substance in the brain that attaches to the same cell receptors that morphine does. Endorphins are released when severe injury occurs, often abolishing all sensation of pain.



Narcotics and Chronic Pain of RSD



The management of acute vs. chronic pain requires a completely opposite approach. Whereas in severe acute pain the use of narcotics in vital and essential, in chronic pain application of narcotics is contraindicated and dangerous.

Approaches such as the use of Dilaulid as a focal perfusate in the RSD extremity make no sense. Although the narcotic results in immediate relief of pain it is followed by an exaggerated painful withdrawal.

Oral or intramuscular (i.m.) application of narcotics flood the CNS with resultant inhibition of endorphin formation followed by severe pain of withdrawal.

For the purpose of lasting analgesia - in chronic pain of RSD - the CNS should be stimulated to form more endorphins. The use of narcotics results in a marked inhibition and reduction of endorphins. Exercise and proper nutrition stimulate the formation of endorphins.

The chemical treatment of choice for chronic pain of RSD is antidepressants or ACTH, both of which raise the concentration of endorphins in CNS.

This is from another site where they are discussing how important some type of exercise is to us (walking or water exercise are good options) because exercise triggers the release of endorphins in the body.

Blümberg, Jänig and Koltzenburg have discovered a new source of pain. It originates from the deep chemoreceptor c-fibres in muscle and bone. These chemoreceptors become activated with inactivity. Intermittent walking reduces the incidence of deep pain." (1 ) This explains why exercise is crucial in treating RSD/CRPS. Physical activity also triggers the release of endorphins, pituitary gland hormones, that function as natural opiates. Endorphins are considered to be 200 times more potent than morphine.(6) The word endorphin means "morphine within".

Many people with chronic pain do not manufacture enough endorphins, this causes two problems. The first is that your body is sending inappropriate pain messages, and it is not releasing endorphins to protect against the pain. The second is a lack of sufficient endorphins causes hypersensitivity to pain. There are ways we can work to increase our endorphins naturally and with medications.

Naturally occurring endorphins can be obtained by: 1. Exercise 2. Biofeedback, Meditation, Prayer 3. Bodywork, Massage, Hydrotherapy 4. Laughter. Endorphin research suggests that there is a link between our emotional state and the health and well-being of our immune systems. So pleasant memories, exercise, sexual activity, laughter, are all ways we can increase our levels of endorphins and therefore help our body to fight pain through its own natural chemicals.(7)

Here is the website if you want to read more http://www.artzoo.com/health/rsdcrps.htm

This is some more information that explains about what Endorphins are and how they are released in the body. Also how important laughter is to all of us.

Endorphins belong to a class of biochemicals commonly referred to as neurohormones that act by modifying the way in which nerve cells respond to transmitters. The discovery of this class of biochemicals has an unusual and interesting history. In the 1960s, biomedical researchers studying the causes and effects of opium addiction had detected what they suspected were "opiate receptors" in brain tissue. Since it seemed quite unlikely that humans (or other vertebrates) would contain a specific receptor designed for a chemical derived from the poppy plant, the researchers focused their attention on biochemicals that might be synthesized in the brain itself. Early in the 1970s, several small peptides were isolated that appeared to possess natural analgesic properties, and these were collectively termed enkephalins and endorphins. The modification of neural transmissions by these biochemicals now appears to be responsible for the insensitivity to pain that is experienced by individuals under conditions of great stress or shock. The effectiveness of analgesic opiate derivatives such as opium, morphine, and heroin is an accidental side effect that derives from the ability of these substances to bind to neurohormone receptors despite their very different structure.


alpha-Endorphin
Four distinct groups of endorphins have been identified to date. They have been termed: alpha-endorphin, a polypeptide with 16 residues; beta-endorphin, a polypeptide with 31 residues; gamma-endorphin, a polypeptide with 17 residues; and sigma-endorphin, a polypeptide with 27 residues. These different types of endorphins, like all known polypeptide hormones, are synthesized in a "prepro" form that is one gigantic polypeptide with a signal sequence and additional sequences that are cleaved out during posttranslational maturation of the polypeptide. The most interesting example of this is the pituitary multihormone precursor termed pro-opiomelanocortin that contains the sequences for beta-lipotropin, melanocyte-stimulating hormone (MSH), endorphins, enkephalins, and adrenocorticotropic hormone (ACTH). After synthesis, this peptide is cleaved in the pituitary to generate ACTH and beta-lipotropin, while processing in the central nervous system produces endorphins and enkephalins, along with some other products.


beta-Endorphin
Endorphins are most heavily released in the human body during stressful events or in moments of great pain. The rush of endorphins into the system at such times is often felt as a queasy or nervous feeling in the stomach. However, the amount of endorphins released by individuals varies so that an occurrence that stimulates significant neurohormone secretion in some people will not necessarily do so in others. In addition to stress and pain, endorphin secretion may be triggered by the consumption of certain foods, such as chocolate and chili peppers. Indeed, the characteristic increase in bodily endorphin levels caused by chocolate is believed to play a significant role in its often being turned to as a comfort food in times of stress. Moreover, due to the endorphin release associated with chili peppers, they have been utilized in various kinds of medical treatments, especially as part of therapy for chronic pain, and are sometimes considered an aphrodisiac. Certain kinds of physical activity have been associated with endorphin secretion in recent years as well. Undergoing massage therapy or acupuncture, for example, is believed to stimulate endorphin release, and the natural painkillers may be responsible for the euphoric feelings known as "runner's high" and "adrenaline rush."


gamma-Endorphin
Perhaps the most unusual activity believed to be able to stimulate the body's secretion of endorphins is laughter. Medical studies have shown that good belly laughter can reduce stress hormones, decrease pain, lower blood pressure, and even boost the immune system. Due to such findings, laughter has begun being used as a sort of adjunctive therapy to other forms of medical treatment. Contemporary interest in the therapeutic capabilities of laughter was sparked in the 1970s when a book written by Norman Cousins was published, which related his use of Marx Brothers films and humorous stories to help alleviate pain he had been suffering from ankylosing spondylitis, a disease that attacks the connective tissues of the body. Though Cousins initially received significant criticism, his work was fully vindicated in 1989 when the Journal of the American Medical Association published an article by Swedish scientist Lars Ljungdahl entitled "Laugh If This Is a Joke," which argued that "a humor therapy program can increase the quality of life for patients with chronic problems" and "laughter has an immediate symptom-relieving effect for these patients, an effect that is potentiated when laughter is induced regularly over a period." Thus one might be inclined to agree with the great American humorist Mark Twin who suggested, "The human race has only one really effective weapon, and that's laughter."





I hope you enjoyed reading about Endorphins and how they help pain levels as well.

I think I am going for a walk I'm convinced it helps. How do you feel about endorphins? Have you noticed you feel a little better when you meditate, laugh or take a walk? I remember when I asked my doctor why I am so tired all the time and he suggested taking a short walk everyday and I looked at him like he had two heads. I remember thinking if I am already exhausted how could that possibly help? Well after reading about it I feel enlightened to say the least. Do you have any thoughts about Endorphins and RSD. I would love to hear your opinion or experiences as always. Just add it to this post. Remember keep smiling

Love,

Robyn
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RSD and the Sympathetic Nervous System Empty continued.....

Post  byrd45 Mon Jan 05, 2009 7:32 pm

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From: FiNdAcUrEnOw
Message 2 in Discussion

Thanks so much Robyn, the sympathetic nerve system info you posted is great. I have read all this information many times and heard it all many times from doctors and others, but you think your taking it in and understand it all and then sort of forget it sometimes. Reading it again, especially the way you posted it really helps. It helps understand why, I sweat like a running facet from the chest up sometimes for no reason at all and when everyone else says it's not warn in here, it helps understand why I have horrible insomnia, it helps understand why I have terrible digestive problems, it helps understand why I have horrible anxiety attacks, it helps understand why I have weird muscle spasms, it helps to understand why the evil weight gain, it helps remind me this comes from the spinal cord somehow and that is how it spreads, to sit and wonder how can another part of my body suddenly have the exact same symptoms as the injured part did when it was 1st injured, when this other new body part was never injured? It's because it spreads through the spinal cord and that connects pretty much everything, and then there is the memory problems, the feeling your gonna lose your mind sometimes, it helps understand why I get a lot of other strange things pop up that I wonder, "what is this." Reading and remembering the things I already read before but somehow forget, really helps. I just wanted to thank you for posting the info you posted. Now I know probably most of us who suffer from RSD understand this, I hope so anyway, if anyone who has this doesnt understand it, it would be enough to drive them mad, so I hope anyone who never had it explained to them reads this, and more, to really understand what you have, it's really very important. But, like I was saying we probably all understand it, but to explain it to others who don't have it, boy is that a crazy one, you tell someone I have RSD. Well, 99.9% of the people you say that to will have no idea what it is. So say well, its a nerve thing? Its a set of nerves we all take for granted until they don't function properly and then it's sort of a case where a certain set of our nervous system called the Symathetic Nervous System sort of goes haywire and misfires, and wrongly tells our body things are happening to it, when they should'nt be telling it that. It's a real hard thing to tell someone. Most really don't understand even if you try to explain it. How do you tell someone, well I have excruciating pain in this arm or leg and I have never done anything to injure it. You say this disorder is telling my arm or leg that it is injured and in pain, it's wrong, but the body doesnt know that. Haha! I don't try to explain anymore, I just say it's a nerve disorder and causes severe pain, there is a lot more to it, but I really can't explain it, if you have any free time, maybe you might look it up on the internet, it's called RSD/CRPS. And they can explain it a lot better. Well, I did it again, wrote too much, but thanks again for posting that information Robyn.

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From: byrd45 Sent: 9/22/2005 11:32 AM

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From: <NOBR>irisheyes0720</NOBR> Sent: 8/31/2005 1:32 PM
Thanks so much for the article I really could realte to it as it is exactly what the Pain Specialist told me and that was one of the tests he ran to prove to anyone that I had RSDS unfortunately the BWC does not believe that. Thaks Irish



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From: <NOBR>byrd45</NOBR> Sent: 8/31/2005 6:18 PM
Hi Irish,
I am glad you enjoyed it! How is your week going? WC never wants to hear the truth when someone is hurt like we are. You and your doctor know the truth and they will have to deal with it anyway. Doing anything special for Labor Day? I was invited to a party but not sure what we are doing yet. Talk to you soon.
Love,
Robyn


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From: <NOBR>irisheyes0720</NOBR> Sent: 8/31/2005 9:08 PM
I am counting down the days to the weak end so that I can have three whole days off work. I love working and would feel worse than I do now if that was possible but work keeps me going. I will probably go over to some friends for Labor Day. . I was invited to Columbus for a party but that would be pushing it to much. Thanks for all the valuable information and jokes I really do look forward to reading them. You are a terrific person and this group is very lucky to have you and I agree with you on Paula Abdul. It took people like us to put her were she is today and it can take people like us to destroy her image whatever that is. If she is back on American Idol I for sure will never be watching it. Her power behind the press should of been used to inform people about raising awareness to people who have RSDS and Bulimia not her nail polish or her latest boyfriend. Hugs Irish
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From: <NOBR>byrd45</NOBR> Sent: 8/31/2005 9:20 PM
Hi Irish,
I hope you have a great weekend you deserve it! Hey this group is lucky to have too! I really do feel lucky to know everyone here. We all are survivors. We didn't ask for this life but at least we are all trying our best to live it to the fullest. Thank you from the bottom of my heart! You are so right she should have used her power and I am mad about her selfishness too. Shame on her. Enjoy your time off and talk to you soon.
Love,
Robyn
----- Original Message -----
From: irisheyes0720
To: RSDOutreach@groups.msn.com
Sent: Wednesday, August 31, 2005 9:08 PM
Subject: Re: RSD and the Sympathetic Nervous system(a part of the Autonomic System)


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New Message on RSD Outreach

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From: irisheyes0720
Message 6 in Discussion




I am counting down the days to the weak end so that I can have three whole days off work. I love working and would feel worse than I do now if that was possible but work keeps me going. I will probably go over to some friends for Labor Day. . I was invited to Columbus for a party but that would be pushing it to much. Thanks for all the valuable information and jokes I really do look forward to reading them. You are a terrific person and this group is very lucky to have you and I agree with you on Paula Abdul. It took people like us to put her were she is today and it can take people like us to destroy her image whatever that is. If she is back on American Idol I for sure will never be watching it. Her power behind the press should of been used to inform people about raising awareness to people who have RSDS and Bulimia not her nail polish or her latest boyfriend. Hugs
Irish
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RSD and the Sympathetic Nervous System Empty RSD and the Sympathetic Nervous System

Post  byrd45 Mon Jan 05, 2009 7:28 pm

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From: byrd45 (Original Message) Sent: 9/22/2005 11:26 AM
Hi Everyone,
I thought today it would be interesting to discuss Rsd and the Sympathetic Nervous System. I have heard this brought up many times in discussions with my doctor about my RSD, and in reading articles about RSD. Whether this term is new or old to you I hope you will enjoy reading about how the Sympathetic Nervous System works.After reading about this information it sure makes sense to me why we have alot of the symptoms we do. As always I would love to hear your input or comments about RSD and the sympathetic nervous system.Here is the information I found...........
It is the sympathetic nervous system that is involved in the disease RSD. The sympathetic nervous system prepares the body for the “fight or flight” reaction. It accelerates heart rate, constricts blood vessels, and distributes blood to the brain, heart and muscle. RSD is thought to be a result of excitation of peripheral nerve elements with an abnormal and severe sympathetic response resulting in the pain and signs and symptoms of RSD.

The sympathetic nervous system and the central nervous system work together to maintain normal body functions, but RSD causes a malfunction of the sympathetic nervous system. This can lead to symptoms of severe, burning pain, extreme sensitivity to touch, swelling, excessive sweating, and changes in bone and skin initially in the area that has received some type of trauma.
‘The diagnosis of reflex sympathetic dystrophy may be established by sympathetic blockade, regardless of whether that is carried out using regional sympathetic nerve blocks or systemic sympatholytic agents. The classical sympatholytic test is a sympathetic ganglion block using a local anesthetic. However, it is important that the results of the block are interpreted carefully. It is important to know whether the sympathetic blockade is complete, especially in patients who do not experience significant pain relief.

If a patient does not obtain relief, is it because the mechanism is not sympathetic or because the block has been improperly placed? The efficacy of sympathetic blockade can be objectively assessed by evaluating the effects on sympathetic, sudomotor, and vasoconstrictor function, measuring changes in skin blood flow, skin temperature, and skin resistance. In patients who do obtain pain relief from a sympathetic block, it is important to do a careful sensory examination, since local anesthetic can directly spread to the nearby nerve roots, resulting in a somatic nerve block.’


The Autonomic Nervous System

The organs (the "viscera") of our body, such as the heart, stomach and intestines, are regulated by a part of the nervous system called the autonomic nervous system (ANS). The ANS is part of the peripheral nervous system and it controls many organs and muscles within the body. In most situations, we are unaware of the workings of the ANS because it functions in an involuntary, reflexive manner. For example, we do not notice when blood vessels change size or when our heart beats faster. However, some people can be trained to control some functions of the ANS such as heart rate or blood pressure.
The ANS is most important in two situations:


In emergencies that cause stress and require us to
"fight" or take "flight" (run away)
and


In nonemergencies that allow us to "rest" and "digest.".



The ANS regulates:

Muscles
in the skin (around hair follicles; smooth muscle)
around blood vessels (smooth muscle)
in the eye (the iris; smooth muscle)
in the stomach, intestines and bladder (smooth muscle)
of the heart (cardiac muscle)
Glands
The ANS is divided into three parts:


The sympathetic nervous system
The parasympathetic nervous system
The enteric nervous system.



The Sympathetic Nervous System
It is a nice, sunny day...you are taking a nice walk in the park. Suddenly, an angry bear appears in your path. Do you stay and fight OR do you turn and run away? These are "Fight or Flight" responses. In these types of situations, your sympathetic nervous system is called into action - it uses energy - your blood pressure increases, your heart beats faster, and digestion slows down.
Notice in the picture on the left that the sympathetic nervous system originates in the spinal cord. Specifically, the cell bodies of the first neuron (the preganglionic neuron) are located in the thoracic and lumbar spinal cord. Axons from these neurons project to a chain of ganglia located near the spinal cord. In most cases, this neuron makes a synapse with another neuron (post-ganglionic neuron) in the ganglion. A few preganglionic neurons go to other ganglia outside of the sympathetic chain and synapse there. The post-ganglionic neuron then projects to the "target" - either a muscle or a gland.

Two more facts about the sympathetic nervous system: the synapse in the sympathetic ganglion uses acetylcholine as a neurotransmitter; the synapse of the post-ganglionic neuron with the target organ uses the neurotransmitter called norepinephrine. (Of course, there is one exception: the sympathetic post-ganglionic neuron that terminates on the sweat glands uses acetylcholine.)








The Parasympathetic Nervous System
It is a nice, sunny day...you are taking a nice walk in the park. This time, however, you decide to relax in comfortable chair that you have brought along. This calls for "Rest and Digest" responses. Now is the time for the parasympathetic nervous to work to save energy - your blood pressure decreases, your heart beats slower, and digestion can start.
Notice in the picture on the left, that the cell bodies of the parasympathetic nervous system are located in the spinal cord (sacral region) and in the medulla. In the medulla, the cranial nerves III, VII, IX and X form the preganglionic parasympathetic fibers. The preganglionic fiber from the medulla or spinal cord projects to ganglia very close to the target organ and makes a synapse. This synapse uses the neurotransmitter called acetylcholine. From this ganglion, the post-ganglionic neuron projects to the target organ and uses acetylcholine again at its terminal.

Here is a summary of some of the effects of sympathetic and parasympathetic stimulation. Notice that effects are generally in opposition to each other.






The Autonomic Nervous System
Structure Sympathetic Stimulation Parasympathetic Stimulation
Iris (eye muscle) Pupil dilation Pupil constriction
Salivary Glands Saliva production reduced Saliva production increased
Oral/Nasal Mucosa Mucus production reduced Mucus production increased
Heart Heart rate and force increased Heart rate and force decreased
Lung Bronchial muscle relaxed Bronchial muscle contracted
Stomach Peristalsis reduced Gastric juice secreted; motility increased
Small Intestine Motility reduced Digestion increased
Large Intestine Motility reduced Secretions and motility increased
Liver Increased conversion of
glycogen to glucose
Kidney Decreased urine secretion Increased urine secretion
Adrenal medulla Norepinephrine and
epinephrine secreted
Bladder Wall relaxed
Sphincter closed Wall contracted
Sphincter relaxed


It should be noted that the autonomic nervous system is always working. It is NOT only active during "fight or flight" or "rest and digest" situations. Rather, the autonomic nervous system acts to maintain normal internal functions and works with the somatic nervous system.
The enteric nervous system is a third division of the autonomic nervous system that you do not hear much about. The enteric nervous system is a meshwork of nerve fibers that innervate the viscera (gastrointestinal tract, pancreas, and gall bladder).




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From: <NOBR>FiNdAcUrEnOw</NOBR> Sent: 8/31/2005 7:30 AM
Thanks so much Robyn, the sympathetic nerve system info you posted is great. I have read all this information many times and heard it all many times from doctors and others, but you think your taking it in and understand it all and then sort of forget it sometimes. Reading it again, especially the way you posted it really helps. It helps understand why, I sweat like a running facet from the chest up sometimes for no reason at all and when everyone else says it's not warn in here, it helps understand why I have horrible insomnia, it helps understand why I have terrible digestive problems, it helps understand why I have horrible anxiety attacks, it helps understand why I have weird muscle spasms, it helps to understand why the evil weight gain, it helps remind me this comes from the spinal cord somehow and that is how it spreads, to sit and wonder how can another part of my body suddenly have the exact same symptoms as the injured part did when it was 1st injured, when this other new body part was never injured? It's because it spreads through the spinal cord and that connects pretty much everything, and then there is the memory problems, the feeling your gonna lose your mind sometimes, it helps understand why I get a lot of other strange things pop up that I wonder, "what is this." Reading and remembering the things I already read before but somehow forget, really helps. I just wanted to thank you for posting the info you posted. Now I know probably most of us who suffer from RSD understand this, I hope so anyway, if anyone who has this doesnt understand it, it would be enough to drive them mad, so I hope anyone who never had it explained to them reads this, and more, to really understand what you have, it's really very important. But, like I was saying we probably all understand it, but to explain it to others who don't have it, boy is that a crazy one, you tell someone I have RSD. Well, 99.9% of the people you say that to will have no idea what it is. So say well, its a nerve thing? Its a set of nerves we all take for granted until they don't function properly and then it's sort of a case where a certain set of our nervous system called the Symathetic Nervous System sort of goes haywire and misfires, and wrongly tells our body things are happening to it, when they should'nt be telling it that. It's a real hard thing to tell someone. Most really don't understand even if you try to explain it. How do you tell someone, well I have excruciating pain in this arm or leg and I have never done anything to injure it. You say this disorder is telling my arm or leg that it is injured and in pain, it's wrong, but the body doesnt know that. Haha! I don't try to explain anymore, I just say it's a nerve disorder and causes severe pain, there is a lot more to it, but I really can't explain it, if you have any free time, maybe you might look it up on the internet, it's called RSD/CRPS. And they can explain it a lot better. Well, I did it again, wrote too much, but thanks again for posting that information Robyn.


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From: <NOBR>byrd45</NOBR> Sent: 8/31/2005 9:05 AM
Hi Findacure,
I am so glad it helped get things in order in your mind. I felt the same way too. Some articles are so technical that it just went and flew right on over my head. I understand exactly what you were saying about the symptoms we all have and how people get that glazed look in their eyes whenever I try to explain it. I always at this point just say I have a disease of the nervous system called RSD. That they seem to understand. It has helped me a lot to research RSD so that I understand what is happening to my body and it makes me feel a little better with all the odd things that happen as part of the RSD. That is the one way we can feel that we have some kind of control in an impossible situation. As for your posts being too long, I wouldn't worry about that because I enjoy hearing from you! Don't you even give it a second thought. Talk to you soon!
Love,
Robyn
----- Original Message -----
From: RSD Outreach
To: RSD Outreach
Sent: Wednesday, August 31, 2005 7:30 AM
Subject: Re: RSD and the Sympathetic Nervous system(a part of the Autonomic System)



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