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 #47
The Effects of Surgery on RSD Patients

Question:

Dear Dr. Hooshmand,

My daughter is 22 year old and has RSD. She had a simple knee trauma, treated initially with PT and NASI but a new physician determined she needed surgery and she had arthroscopic followed by an open release of the tendon. The retinucalar release was "over-released" causing the patella to go off track medically discovered by the physical therapist. The surgeon did not believe anything wrong. My daughter complained of a pain much greater than pre-op and he told her she should grow up and not be a chronic complainer. It was documented in her Physical therapy, her tolerance to ice and increased pain, we knew of RSD at this point. Six months later her RSD was diagnosed and more surgery was done to reverse the ligament repair. This got rid of one pain but caused an increase in RSD symptoms. She is now going downhill, her mobility is severely impaired complicated by orthopedic problems, the Orthopaedist  says fix the RSD, the Neurologists says fix the orthopaedic problems. It has been a royal run around and all the time I see her getting worse and her pain increasing. Now she is being sent to a clinic. Thank you for listening, we appreciate all your work with RSD and your input.

Pat

Answer:

Dear Pat,

I truly empathize with your plight. What you daughter is going through is nothing but the routine of the "Miracle of Modern" medicine. She is simply caught between a rock and a hard place. They are offering to her nothing but sticking a spinal stimulator in her or operating on the knee. Both being operative surgical procedures stimulating the RSD rather than calming it down. As I warned you several months ago muscle spasm around the knee suffering from RSD will pull the patella to one side. Instead of proper physical therapy and muscle relaxants they did an operation to make it look good. She did not need esthetic surgery, which only made the RSD worse. It is time to "say No" to any surgery. She needs to be in a comprehensive, multidisciplinary, assertive and conservative treatment. Sending her to the Clinics that have the policy of inserting a spinal cord stimulator (SCS) in RSD patients is not in the best interest of your daughter.

H. Hooshmand, M.D.