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Beverly Hills
9301 Wilshire Boulevard
Beverly Hills, California 90210
Wilmington
123 F St., Suite G
Wilmington, California 90744
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INSURANCE & WORKERS' COMPENSATION
ACCEPTED!
We accept most types of insurance
providers and specialize in the treatment of workers'
compensation injuries to the hand and upper extremity. |
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Reflex Sympathetic Dystrophy (RSD)
Vulnerabilites and Gender
Signs & Symptoms of RSD
Diagnosis & Medical History
Treatments & Early Detection
Long Term Effects of RSD
Also known as chronic regional pain syndrome, reflex sympathetic dystrophy
or RSD shows up as highly increased sensitivity in the hand or other
extremity, along with pain and swelling. The pain that is felt is
rather intense, and RSD usually accompanies some minor cut or injury.
If RSD is present, a small bruise or paper cut will make the nerves
"misfire" and send frequent or constant signals to the brain
registering pain. The sympathetic nerves, which transmit sensations
of pressure, heat, or pain to the brain, become overactive resulting
in feelings of intense burning or aching pain. In addition to such
sensations, the area may become swollen and there may be changes in
the coloring or temperature of the skin.
| Vulnerabilities & Gender |
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Women are three times more likely than men to be affected by RSD,
although it can strike anyone. It shows up most often between the
ages of 25 and 55, and between three and six million Americans are
believed to suffer from this condition.
RSD often shows up following a minor injury such as a sprain
or small cut, but can come from any injury
to a nerve.
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| Signs & Symptoms of RSD |
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RSD usually shows up as a constant, severe, burning pain that is felt
somewhere other than the actual site of the injury. The pain is far
greater than that which should result from the injury incurred and
typically lasts longer than expected as well. There may be swelling,
confined to one spot or over the entire extremity.
There may be excessive hair growth in the area, or the nails may grow
much faster than usual. The skin in the area affected may feel warmer
to the touch than the surrounding areas, and may look thin and shiny
compared to the rest of the body. There may also be increased sweating,
but only in the affected area.
If RSD is in the hand, the movements and motions of the hand will
be reduced or limited. Any of the symptoms that normally go along
with RSD can vary in intensity and can continue for various lengths
of time.
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| Diagnosis & Medical History |
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If RSD is suspected, one of our skilled hand surgeons will conduct
an examination and record a thorough history of the patient. Although
there is no simple, definitive test for the condition, x-rays, thermography,
and bone scans are sometimes helpful. Your hand surgeon may wish to
consult with a specialist to confirm the diagnosis, and use of a pain
clinic is often recommended.
One test that can be used to strengthen the diagnosis is a stellate
ganglion block. If the patient has a good response to the block, RSD
is more likely.
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| Treatments & Early Detection |
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The chances of fully recovering from RSD are better if the diagnosis
and treatment begin when the condition is at an early stage. How severe
the symptoms are, and how long they last, are often the deciding factors
in choosing the most appropriate treatment method.
The goal of all treatments for RSD is to restore use of the hand or
other extremity as much as possible and relieve painful symptoms so
that patients can resume their daily activities. If a nerve is irritated,
or some other chronic physical problem exists, the treatment will
also seek to relieve that problem.
The following treatment options, often in combination, may be used
to treat RSD:
Therapy - Used to save as much function and movement as
possible, or to try to restore lost use, an exercise program for
the affected hand
Psychotherapy - Useful because patients with RSD often also suffer
from depression, post-traumatic stress disorder, or anxiety and
the condition causes deep psychological effects
Sympathetic Nerve Blocks - Injection of a local anesthetic
into the stellate ganglion, a cluster of nerves at the base of the
neck, may produce significant relief from pain and accompany more
effective therapy
Medication - Topical analgesics, antidepressants, anti-seizure drugs,
opiods, and corticosteroids can be helpful
Surgery - Used to release pressure on a compressed nerve, such as with
carpal tunnel syndrome. Although controversial, an operation called
a sympathectomy that divides the sympathetic nerve, may help a patient
who responds well to nerve blocks. Spinal cord stimulation and intrathecal
drug pumps that inject pain medication continuously around the spinal
cord can be used in extreme cases.
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| Long Term Effects of RSD |
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Those with RSD respond differently to the various treatments. Some
people experience spontaneous remission while others may experience
crippling and irreversible changes despite the treatment. Early treatment
of the condition is generally considered to be helpful, but more research
is needed to come up with the causes of RSD as well as how it develops
or responds to treatment.
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