RSD Puzzle #128

H. Hooshmand, M. D.

DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY

BOARD CERTIFIED IN ELECTROMYOGRAPHY

BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE

INTRACTABLE NEUROLOGY

EPILEPSY, PAIN, MS

An International Referral Center dedicated to Treatment, Education and Research

RSD PUZZLE # 128

Sporadic Changes in CRPS/RSD

Question:

Dear Dr. Hooshmand,

I am told that I have RSD, but at times my doctor does not think that I have RSD because the swelling and color changes are not always present when he examines me. He keeps giving me Elavil which makes my condition worse. Can RSD cause severe spasms of muscles?

Thank you

Ms. R

Answer:

Dear Ms. R,

Many thanks for your e-mail letter regarding your RSD.

1. The swelling and changes in CRPS/RSD are always intermittent and sporadic. Trigger point injections are not enough. You need epidural blocks and plexus nerve blocks (such as brachial plexus blocks).

2. Severe spasm and jerking movement of the extremities are very common in CRPS/RSD. The treatment of choice for these is Klonopin (Brand name, which I believe in Canada is called Rivotril).

3. MS Contin and MSIR are effective for cancer pain patients, but don’t relieve the neuropathic pain of CRPS (RSD).

4. The ideal analgesic anticonvulsant are:

a. Trazodone

b. Desipramine

c. Doxepin

H. Hooshmand, M.D.

Copyright © 1997-2012 H. Hooshmand, M.D. No part of this publication may be reproduced, transmitted, stored in a retrieval system other than this specific media, transcribed, or translated into any language without the expressed written permission from the author; H. Hooshmand, M.D. and Eric Phillips and CMNE. This material is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician.

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The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2012 H. Hooshmand, M.D.