FWD:Treatment Overview for RSD

RSD In the News : FWD:Treatment Overview for RSD
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From: byrd45 (Original Message) Sent: 7/15/2005 9:39 AM
Treatment
The goal of treatment is pain control and as much mobilization of the affected limb as possible. An individualized treatment plan is designed, which often combines physical therapy, medications, nerve blocks, and psychosocial support.

Medication Medications are prescribed to control pain. The type of pain experienced by the patient determines the type of medication prescribed.

Constant pain caused by inflammation is treated with nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen, naproxen, indomethacin).

Constant pain not caused by inflammation is treated with central acting agents such as tramadol (Ultram).

Stabbing pain and pain that disrupts sleep are treated with antidepressants such as amytriptyline, doxepin, nortriptyline, and trazodone. Oral lidocaine, a somewhat experimental treatment for RSD/CRPS, also may be prescribed.

Sudden sharp pain may be treated with anticonvulsants (e.g., carbamazapine, gabapentin).

Generalized, severe pain that does not respond to other medications may be treated with opioids (e.g., propoxyphine, codeine, morphine).

Muscle cramps (spasms and dystonia) can be treated with clonazepam and baclofen.

Localized pain related to nerve injury may be treated with Capsaicin cream, but its effectiveness has not been proven.

Medications that block selected actions of the sympathetic nervous system, such as clonidine (Catapres, available in oral and patch formulations), can be useful in some cases.

Muscles stiffness may be treated with muscle relaxants such as

Tizanidine (Zanaflex)
Baclofen
Clonazepam (Klonopin)
Physical Therapy
Physical therapy should include daily range of motion exercises. Patients should be advised to avoid activities that could accelerate osteoporosis or joint injury.