RSD Puzzle #131

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 #131

Destructive lesion cause more pain and aggravation of CRPS

Dear MG.,

Thanks for the 3 questions that you e-mailed to me. The answer is a strong no to all 3 questions.

1. SCS has quite a high risk of aggravation of pain, and spread of the disease to other parts of the body. If it is not helping your pain, it should be removed because it acts as a foreign body. As such, it stimulates and aggravates the CRPS.

2. In regards to Capsaicin experiment, it is not a good idea for you to become a so called "Guinea Pig". Capsaicin, the extract of jalapeno pepper, is a strong chemical irritant identical to substance P (pain substance). It is a major aggravator of pain and inflammation in CRPS patients. The reason it has been used for treatment of pain, is because it destroys the sensory nerves in the skin, causing temporary sensory loss followed by recurrence and spread of neuropathic pain of CRPS. In the long run, it does the same damage as ice application, they both destroy sensory nerves, causing spread of pain and CRPS.

3. Cryogenic surgery (Cryosurgery), which means freezing an organ in the body, is similar to radiofrequency surgery, which means destroying nerve fibres at boiling hot temperature.

We have yet to see even one patient who had pain relief in the long run after such destructive (ablative) surgical procedures. These surgical treatments provide a few days or weeks of pain relief because of permanent damage to nerves. After a few weeks, the surrounding partially damaged nerves start getting caught in the dead tissues, causing more severe pain than the original injuries.

With many thanks,

H. Hooshmand, M.D.

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