Workers' Compensation Discussion Forums

Anyone ever heard of RSD and how to determine diagnosis? After three surgeries think that I may have RSD or a form of it.

spring and sithie both have rsd try and PM them or they will be around soon

you can also check out rsd.org

RSD is a clinical diagnosis. Symptoms include color change in the affected extremity, extreme pain, hair loss on affected extremity and changes to finger or toe nails. Sweating of the affected extremity is also looked for. The only diagnostic test I am aware of is a bone scan, but that is far from full proof.

Google RSD or CRPS and you will come up with tons on information. RSD.org, as suggested by Pooh, is a very good site.

A bone scan is only 55% accurate if you have the RSD in only one limb and pretty much useless if you have the RSD in both limbs, because the scan compares the blood flow between limbs.

Here are some general symptoms of RSD:

Characteristic signs and symptoms of sympathetic nervous system involvement are

Burning pain
Extreme sensitivity to touch
Skin color changes (red or bluish)
Skin temperature changes (hot or cold)

Pain is usually disproportionate to the degree of injury and can be triggered by disuse of the affected limb or by stress. It can be spontaneous or constant.

Symptoms associated with an immune reaction include:

Joint pain
Redness
Swelling (edema)
Frequent infections

Signs of motor system dysfunction include the following:

Difficulty starting movement
Increased muscle tone, stiffness
Muscle spasm
Tremor
Weakness

Other symptoms include include the following:

Dermatitis, eczema (inflammation of the skin)
Excessive sweating
Fatigue
Migraine headache
Finger Nails, fast growth, brittle
Hair thinning

Complications

Patients with any chronic illness, including RSD/CRPS, often suffer from depression and anxiety. Skin, muscle, and bone atrophy (wasting) are possible complications of the syndrome. Atrophy may occur because of reduced function of the affected limb.

When i first had my injury in Jan. of this year my wrist was swollen and it hurt to even breath on it. I broke out in a rash on that arm only and had hot and cold and color changes with my hand. I went to many doctors and noone would diagnose me with RSD. I swore i had it. I go to the pain clinic monthly now and they diagnosed me with recurring carpal tunnel ( as i had the open surgery in 98 ) and they would not repeat the surgery. I also have neuropathy in that hand/wrist. I had a very hard time getting anyone to diagnose me with it and the neurologist that did the second EMG said in his report that all my symptoms were RSD related.

What i am saying is.......there is about 6 things i heard my pain clinic doctor say to the fellow at the clinic that would prove a person has RSD. I had all of them listed above and they still refused to do further testing and diagnose me with it. They must of been right, as now i do not have them symptoms today. When the pain was really bad i was eatting the perc's and vicodin when i had them like they were candy. I could not get any relief no matter how much i took. The pain was so intense. The only thing that i found that worked for the pain was Methadone 20 mg a day and percs for breakthrough pain. The methadone worked so well i had no need for the percs. The only downfall was i sweated like crazy and itched like hell on it. I just got off them last week and went to Oxycontin. I find these work very well and no longer sweat like a pig. I suggest you get Methadone first instead of trying all the other narcotics. It did wonders for the pain. I wish i would of known about it before i took everything else. Good luck.

Sparkey...Had no idea you were dealing with RSD. I wanted to mention to you that the sweating you are dealing with may be more a symptom of the RSD then a side of the medications. Excessive sweating is one of the signs of RSD....before I had some medications that helps control my sweating....I would have to get up in the night 2-3 times and change P.J's. The same with my shirts during the day. The way to know may be that the sweating is usually worse in the area of the RSD....but also with some RSD people they quit sweating all together. The other thing to watch for is hair growth in the area that is affected such as fast hair growth or no hair growth...like with me...I have no hair growth on my arms or legs any more. And watch your finger nails for changes...my grow all curled downward grooved. The skin gets what they called mottled. They say with most of the research to be diagnosised you will have to have at least 6 of the signs to have RSD it used to be you had to have 8 of the signs. Bone scans are used to diagnosis but so many bone scans were coming back negative...but the Dr's were postive that the patients still had RSD that they say Bone scans just are not always 100% right...I did have a postive bone scan. Know Sithie had what they call a Qusart? sweat test done....and those tests are pretty much right on...for RSD although in the reseach it also says not 100%. So it is said that to be diagnosised you need a very good physical exam by a Dr that understand what RSD is and have atleast 6 of the symtomps. But also having the injections that are for RSD can tell a Dr alot one being where you do have RSD...if your RSD is likely to spread or not....the injection can tell the Dr alot. So I had a postive bone scan..the injections and the injections to tell my Dr that my RSD is one to likely spread. And I have six or more of the signs and symtomps of RSD. In fact when the Dr was able to check my tempature of each of my arms at different times...one is always so much more colder then the other. It does just amaze me that our bodies can do all this stuff....and we can trigger this much pain and wonder sometimes if we will live through it. So when you talked about the pain medications you took or are still taking it doesn't surprise me in the least. But then again we all take different medications to control our pain and symtomps. I know one RSD person on here doesn't take any thing for the pain. And one takes morphine couple times aday. Heck I use a pain patch fentayl and have lortab for the day time. I have taken anti seizure meds...high blood pressure meds...miagraine meds....all of these meds to treat the RSD not what they are designed to do. Plus something to help me sleep and the anti depressants. So I always tell people what works for one person may not work for next. Heck I am at the point I think I would try just about anything if I thought it would control my pain better...and give me more of my active life back...so I could return to work. Lots of new treatment going on in Germany for RSD...and if ever get off WC I just may go there for treatment. So do you think you are in remission....since there is no cure for RSD...or do you still deal with the constant pain....and have the flare ups. Tell me more. I always like to hear from others that are dealing with RSD....Sithie and I talk on the phone several times a week. She has RSD. But just recently got to see one of the best RSD Dr's in the United States. So she is another one that has great information about RSD....But I have been just the wordy one lately.....lol Sithie is just getting over a long trip and bad flare. That is other thing the major flare ups....and they just knock you down in awful pain then you have to deal with all the emotional part of it. With RSD messing up our central nervous system....I really believe it just plays havca with our whole bodies in so many ways. The more I research the more I believe that. Sorry I have written another book. Again hope it makes sense....since now I have taken all my evening medications....lol Good night all,

I could be in remission. I have been off the Methadone a week now and i found a few days i still had bad sweating. This is all over my body not just my arm. Right now i just woke and my shoulder is killing me and i am just about to take my medicine for the day before i go to work. I think the weather also plays a big part. Yesterday it was raining and i felt such a awful nerve pain on the inside of my arm and on the back side of my elbow. Dampness effects it alot. I had a hard time getting anyone to diagnose me with RSD. I had a few doctors suggest i may have it, but noone actually put it on paper.

I would need to go to a RSD doctor in order to find out for sure if i have it or not. All i can say is......god bless you with all that pain. I have felt it so bad that i was bed ridden and would not talk to anyone for days before i was put on meds. I am also on Cymbalta due to that and the nerve pain. It must be working as i can go outside my home now and deal with the world. I do have alot of pain 24/7 and if not for the pain meds i would be crunched back up in my little bed crying again.


My case is put at MMI right now. I will eventually get a test done to see if i have RSD or not. It may of been caused by the carpal surgery i had back in 98. Thank you, and i have also read alot about it when it was suggested i may have it. If this is not RSD that i am experiencing then what the heck is it? Noone will test me any further. Just meds and waiting to heal. I have edema on my inner side of my wrist still and i have not experienced any hair loss, but noticed my nails grow awfully fast now. Thank you for the info.

Sparkey, fight the MMI like hell! RSD is very expensive! Talk to your lawyer face to face and if you dont have one get one. My meds are now running about 16 thousand a year. And that is only meds. I am sorry am not more chatty, Spring nailed it when she said I have been pretty beat up lately, plus I just had the injections, my last hope, and they failed.

Sithie

Bumping this to the top for Lilly,