Robert's fight with RSD

RSD describes a condition, a syndrome, which is also known as Complex Regional Pain Syndrome (CRPS). RSD/ CRPS are considered to be perhaps the most painful of all chronic pain disorders. It involves chronic, excruciating, burning pain, pathological changes in bone and skin, excessive sweating, skin discoloration, and extreme sensitivity to touch, among other symptoms.

Upwards of 1.2 million Americans are estimated to have some form of RSD/ CRPS.  Approximately 50,000 new cases develop, yearly, it is estimated.

RSD is divided into two types. One, called RSD/ CRPS Type I, happens as a result of soft tissue injury, trauma, a fracture, infection, or... where there is no underlying nerve injury. -- RSD/ CRPS Type II refers to cases resulting from major nerve damage. (Type II had previously been known as "causalgia" and dates back to Civil War days.)

RSD/ CRPS affects the following: nerves, skin, muscles, blood vessels and bones, simultaneously. -- Motor, sympathetic, DNIC, and the discriminative & effectual pain system.

The most common and devastating symptom is excruciating pain which is greatly disproportionate to the injury that caused it. Top pain specialists/ and other experts in the field have stressed that RSD pain is not psychologically-based. It is the result of very real injuries sustained by the individual. These injuries alter some of the genetics. The pain and other symptoms become worse as time goes by, unless it responds to treatment.

However, there is no cure, at the present time, for RSD/ CRPS. There are however, cases of remission or adequate control of and lessening of symptoms with treatment. Researchers and doctors have come a long way in the understanding and treatment. And, there are not all that many physicians who have the experience or training to treat RSD/ CRPS.

Symptoms often spread from the originally affected area of the body to other parts of the body. Robert has the worst form, known as 'Full-Body RSD'. Please continue to read more about the care that Robert needs from Dr. Robert Schwartzman, a leading physician in RSD/CRPS care. "It's very common, and it's always missed," said Robert J. Schwartzman, a professor and chairman of the neurology department at Drexel University College of Medicine in Philadelphia.Schwartzman also sees patients at Hahnemann Univer-sity Hospital in Philadelphia.
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Schwartzman and other medical experts who have spent years treating and researching the condition say it is difficult to diagnose.Often, it is misdiagnosed as fibromyalgia, said Schwartzman.
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Despite the confusion over diagnosis, "a tre-mendous amount is known about this," said Schwartzman, who saw his first RSD patient, a 17-yearold woman, 30 years ago.A pioneer in RSD treatment and research, Schwartzman has treated nearly 5,000 patients and was instrumental in establishing the RSD association.The RSD clinic he set up at Jefferson Hospital was later moved to Hahnemann University Hospital.

Schwartzman estimated that three times more women than men get RSD.

Any injury affecting the nervous system can trigger RSD.Fractures, especially those involving the wrist or ankle, sprains, surgery, or any injury to soft tissue are common causes, said Schwartzman.
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Describing RSD as "trauma, peripheral trauma," Schwartzman listed five distinct components common to the condition: pain disproportionate to its cause, swelling, autonomic dysregulation (malfunction in neural control of blood flow to tissues, excess sweating), movement disorder (limbs weaken, spasms, tremors, unable to initiate movement) and atrophy (wasting, deterioration) and dystrophy (muscles weaken).

Those with RSD describe their pain as deep, aching, cold or burning.They also experience increased skin sensitivity.

While experts do not know why injuries develop into RSD in some patients and not others, Schwartzman said research has revealed some important information about the nature of the injuries.For example, he said many of the people who develop RSD had injuries that required a cast.Also, molecules from the injury site had been carried to the spinal cord, said Schwartzman.