Neurological Associates

Pain Management Center

Vero Beach, Florida

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RSD PUZZLE #44
Assistive Devices and Narcotics


1. An extremity suffering from RSD- is not suffering from a simply hyperactive sympathetic system. It suffers from a dysfunctional system. The circulation in the bone and muscle is accelerated at the expense of poor circulation to the skin and nerves. When you use a scooter or any other assistive device, causing non-weight bearing and no exercise, you are exaggerating this abnormal circulation. Eventually the x-ray shows practically no calcium in the bones and shows stress fractures. Then when you try to get out of the scooter to go to the bathroom those fractures and washed out bones can not carry your weight and you become shaky, you feel severe pain ,and fall down. So you go back to the wheelchair never wanting to get out again. Your pain is worse, you need more medicine, resulting in more inactivity.

In the meantime your doctor has done so many nerve blocks on you that there is no more sympathetic ganglion left and the next time you try to sit up your blood pressure falls to practically nothing due to the absence of the protective effect of the sympathetic system. To make matters worse you undergo a spinal stimulator. Your sympathetic system was all messed up in the lower extremity because of a trauma (such as a knee injury or other injury). Inactivity was spreading the RSD to the rest of the body. The trauma of the spinal stimulator causes the spread of RSD to the upper extremities. More narcotics, more inactivity, and you have intractable, uncontrollable RSD.

As long as the patient reverses the process and becomes independent of the wheelchair (or scooter) they can afford the luxury of shopping in a big mall or the once in a lifetime pleasure of Disney World in a wheelchair or scooter.

2. The addictive narcotics are not just suppressing your Endorphins but also ACTH (which prevents inflammation), estrogen (which prevents osteoporosis) and natural cerebral antidepressants.


H. Hooshmand, M.D.

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Copyright © 1997-2006 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 © 1999-2006 H. Hooshmand, M.D.

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This page was last updated on 3/11/2000.