RSD Puzzle #005

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 #5
Why Not Use Ice For RSD Therapy?

"Why not apply alternative ice and heat treatment to the extremity as it is done commonly in the Physical Therapy Departments?"

The practice of alternate ice and heat application only has its place in the neurophysiological experiments and diagnostic tests for the function of the sympathetic system. Application of ice results in stimulation of the sympathetic system and secondary constriction of the superficial sympathetic vasoconstrictors. On the other hand, the heat application results in the dilatation of superficial blood vessels and relaxation of the vasoconstrictor activity of the sympathetic nervous system. Obviously, in RSD, the goal is to warm up the extremity, to dilate the superficial blood vessels, and to slow down the simultaneous inflammation and increased circulation in the deep structures of the extremity (which result in osteoporosis and fracture of the bones). As the heat application helps the patient, the ice application negates the beneficial effects of the heat. The end result is a zero therapeutic effect.

Ice application has its place in acute soft tissue injuries but has no place in treatment of complex chronic pain of RSD.

H. Hooshmand, M.D.

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