FWD:RSD World News-Injuries that Don't Heal

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From: byrd45 (Original Message) Sent: 10/5/2006 6:19 PM
One of the first signs of RSD/CRPS is a minor injury that does not heal and pain which lasts longer than the expected healing time e.g. a sprained ankle or fractured wrist. When the body is injured, it naturally begins the healing process but it is also painful. The process of inflammation is your body's response to injury but it can get out of control and cause more pain. Inflammation begins when the body sends signals to the injured area. The blood flow increases to the wrist/ankle as it begins to fight infection and repair damage. Some extra blood leaks out of the blood vessels and causes swelling, soreness, stiffness and warmth. The blood also sends out strong chemicals which make the area more sensitive.

Normally, inflammation in the body goes away when the injury heals. In RSD, it is different and the nerves are affected. Inflammation is implicated in many kinds of diseases, one of which is RSD/CRPS. The healing process can cause pain in other ways through muscle spasms. When this happens the body contracts muscles near the painful area and those muscles remain tight or in spasm. Why? The spasm itself often hurts. If these spasms are ignored, the muscle tissues can become "glued" together. These spasms can cause great pain if not treated. They can also cause "referred pain" which is pain that is in another location other than the injured area e.g. muscle spasm in the neck can cause a headache.

In addition, the healing process also causes pain when the damaged pain nerves heal improperly. This is quite common since the nerves heal and regrow. Often they do this in a distorted fashion and begin to fire spontaneously sending signals to the brain for no reason at all. Therefore, the very injury that caused the pain in the first place, is not the cause of the continuing pain. The pain has become "engraved upon the nervous system" and is now chronic pain.

An example of this is a study where pain researchers stimulated the thalamus in the brain, the area that first receives pain signals. Those with no history of chronic pain did not have any pain but in chronic pain patients, the patients felt intense pain. The pain had a memory.

In RSD, neurogenic inflammation (of the nerves) can remain, thereby disturbing the healing process. However, the body thinks it is still injured and sends pain signals to the brain. causing more pain. It is like a fire alarm stuck in the "ON" position and it can't be shut off.

The healing process can also cause pain through muscle spasms. When this happens the body contracts muscles near the painful area and those muscles remain tight or in spasm. Why? The spasm itself often hurts. If these spasms are ignored, the muscle tissues can become "glued" together. These spasms can cause great pain if not treated. They can also cause "referred pain" which is pain that is in another location other than the injured area e.g. muscle spasm in the neck can cause a headache. In addition, the healing process also causes pain when the damaged pain nerves heal improperly. This is quite common since the nerves heal and regrow. Often they do this in a distorted fashion and begin to fire spontaneously sending signals to the brain for no reason at all. Therefore, the very injury that caused the pain in the first place, is not the cause of the continuing pain.

The pain has become "engraved upon the nervous system" and is now chronic pain.

Source: Fishman S MD The War on Pain 2002 PARC 2005 PARC PEARL Vol 4 Issue 15