El CRPS está asociado con el desequilibrio y el mal funcionamiento del sistema nervioso autónomo, lo que resulta en discapacidad, deterioro, dolor crónico y pérdida funcional. La International Association for the Study of Pain ha propuesto dividir el CRPS en dos tipos.
Anteriormente conocida como atrofia de Sudeck o distrofia simpática refleja (RSD), no presenta lesiones nerviosas demostrables. La gran mayoría de las personas que padecen SDRC tienen este tipo.
Conocida anteriormente como causalgia, presenta un daño evidente en los nervios. Como regla general, el tipo II se considera el más doloroso de los dos tipos con una puntuación nada envidiable de 47/50 en la escala de dolor de McGill.
Si bien en el pasado se consideraba que el SDRC tenía tres etapas, ahora se cree que los pacientes con SDRC no necesariamente progresan a través de estas etapas o progresan secuencialmente.
Caracterizado por un dolor intenso y quemazón en el sitio de la lesión. Se han reportado espasmos musculares, rigidez de las articulaciones, hinchazón, movilidad restringida, vasoespasmos, crecimiento rápido de las uñas y el cabello, disminución de la temperatura y disminución del rango de movimiento. Esto también se ha denominado “SDRC húmedo”, ya que algunos pacientes pueden experimentar un aumento de la sudoración. Para algunos pacientes afortunados, esta etapa puede durar algunas semanas y luego resolverse por sí sola. Para la desafortunada mayoría, progresa.
Caracterizado por un dolor aún más intenso, descrito por algunos como similar a la sensación de quemarse vivo o ser quemado con un soplete. Se inhibe el crecimiento del cabello; la hinchazón se extiende; la osteoporosis se vuelve severa; las uñas pueden agrietarse, fisurarse, acanalarse o tener manchas; las articulaciones tienden a engrosarse y los músculos se atrofian o encogen, lo que hace que la extremidad afectada parezca más delgada que la otra.
Caracterizada por cambios permanentes en la piel y los huesos, mientras que el dolor se vuelve aún más intenso y ahora puede afectar a toda la extremidad. Se pueden presentar contracciones del tendón flexor y hacer que la extremidad o el apéndice se contraiga (como una garra). Los síntomas pueden extenderse a cualquier otra parte del cuerpo, por ejemplo, los nervios ópticos o el sistema digestivo.
El nervio vago funciona como una autopista de dos vías, pasando señales electroquímicas entre los órganos y el cerebro. En la enfermedad inflamatoria crónica, el tono (o función) vagal bajo causa inflamación en el cuerpo. El alto tono Vagal (o función) provoca la reversión de la inflamación.
Por lo tanto, una buena comunicación entre el sistema inmunológico y el cerebro es vital para controlar la inflamación. Por supuesto, el problema en el cuerpo de los pacientes con SDRC es que el nervio vago hace cualquier cosa menos comunicarse con el cuerpo. Se ha vuelto más como una autopista obstruida por el tráfico, donde pocas señales pasan en cualquier dirección.
Spero Clinic ofrece un breve programa introductorio para quienes buscan alivio del dolor. No es un programa de tratamiento completo, pero aun así sirve como un excelente primer paso para la recuperación.
Si está interesado en nuestro Programa Introductorio Para Pacientes, ofrecemos una consulta telefónica de $49 con la Dra. Katinka.
While CRPS was considered in the past to have three stages, it is now believed that patients with CRPS do not necessarily progress through these stages, or progress sequentially.
Stage 1 is characterized by intense, burning pain at the site of injury. Muscle spasms, joint stiffness, swelling, restricted mobility, vasospasms, rapid nail and hair growth, decrease in temperature, and decreased range of motion have all been reported. This has also been called "wet CRPS" as some patients may experience increased sweating. For a few lucky patients, this stage may last for a few weeks and then resolve on its own. For the unlucky majority, it progresses.
Stage 2 is characterized by even more intense pain, described by some as similar to the sensation of burning alive or being burned with a blowtorch. Hair growth is inhibited; swelling spreads; osteoporosis becomes severe; nails may crack, pit, grooved or have spots on them; joints tend to thicken, and the muscles will atrophy or shrink, causing the affected limb to appear thinner than the other.
Stage 3 is characterized by permanent changes in the skin and bones, while the pain becomes even more intense and now may involve the entire limb. Flexor tendon contractions may be present causing the limb or appendage to contract (much like a claw). The symptoms may spread to any other body part, for example the optic nerves or the digestive system.
While stress (physical, emotional or chemical) causes all disease, it is our belief that CRPS is not the result of one single event or stress, but more like a complicated puzzle, made up of different parts. Stress only affects you adversely physically if you cannot adapt to it. People who suffer from CRPS became overwhelmed to the point that their bodies could not adjust or respond to stress, and CRPS was the unlucky result. Our patients, for whatever reason, (most of the time it is chronic viral infections or childhood trauma) had an imbalanced nervous system prior to developing CRPS. The triggering event is not the cause of the CRPS – it’s just the "straw that broke the camel's back" allowing symptoms to appear.
CRPS is associated with imbalance and malfunction of the autonomic nervous system resulting in disability, impairment, chronic pain, and functional loss. The International Association for the Study of Pain has proposed dividing CRPS into two types.
Type I, formerly known as Sudeck’s atrophy or reflex sympathetic dystrophy (RSD) does not exhibit demonstrable nerve lesions. The vast majority of people suffering from CRPS have this type.
Type II, formerly known as causalgia, has obvious nerve damage present. As a rule, type II is considered the more painful of the two types with an unenviable 47/50 score on the McGill pain scale.
Yes. The most common example of this that we see is CRPS spreading into the GI tract.
This is an extremely subjective and sensitive topic. When the word "cure" is used, that brings to mind visions of a miracle pill, injection, surgery, or perhaps a promising double-blind study excitedly announced by the media. Please believe me when I tell you that it probably won’t happen that way. The failure in finding such a "cure" lies in the theory of what CRPS is or what it is caused by. It is a complex problem, not a puzzle with a single solution. It is not a condition that can be healed by a miracle chemical; it is a body where a whole bunch of things went wrong.
CRPS must be approached by a method where every system involved is checked and rebuilt, if necessary, in a systematic way. We have known hundreds of patients and acquaintances who consider themselves healed from the neurologic symptoms of CRPS. If even one patient can do it, why can't you?
Many patients who suffer from CRPS are able to go into remission from CRPS. Our definition of remission is not having any pain, and being able to resume normal daily activities. Some of our past patients lead very active lives, enjoying activities such as skiing (water and snow), cheerleading, competitive volleyball and weight lifting.
The debilitating pain caused by CRPS is generally described by patients as aching, burning, bone crushing pain in the affected areas of the body. The pain is all consuming, not merely nagging. Things that should not cause pain under normal circumstances (for example, the light brush of fabric or wind) may cause a person who suffers from CRPS intense pain.
Fibromyalgia is a condition that causes the patient to experience chronic pain affecting the entire body that may "jump" from area to area, along with severe, chronic fatigue. Patients who suffer from fibromyalgia often will report that they suffered from some type of old cervical or tailbone injury, such as whiplash or falls. Like CRPS, fibromyalgia is neurologic pain. There is actually quite a bit of overlap between these two conditions, although the pain experienced by CRPS patients is much more intense in nature than that associated with fibromyalgia. CRPS usually confines to one area, unless it spreads. It is possible, and in fact not uncommon, to suffer from both conditions at the same time.
Yes. RSD, or reflex sympathetic dystrophy syndrome, is the previous medical terminology for CRPS. Some medical professionals still refer to CRPS as RSD.
There are several reasons that chronic pain sufferers, including those with debilitating CRPS, hurt more at night. One reason is that lying in one place causes the body's joints to stiffen, increasing joint and muscle pain. The weight of your body may put pressure on your nerves in ways that it doesn’t when you are upright.
Additionally, as your body prepares itself for sleep, your hormone levels, metabolism, and many other biochemical processes adjust. Sometimes, this may result in an increase in your pain. Cortisol, which has anti-inflammatory effects, drops through the first half of your sleep cycle to assist you in sleeping, potentially increasing pain.
Another reason is that our body temperature fluctuates throughout the day and night. Typically, it goes down when we are sleeping. The hypothesis is that damaged nerves might interpret the temperature change as stress, resulting in pain.
Patients may find themselves more focused on the pain at night, as there are fewer natural distractions at night than there are during the day.
You may even find your bedsheets to be contributing to your pain. Almost as if the bed sheets themselves are causing you intense pain.
Overall, it has been shown that chronic pain leads to an average decrease of life expectancy of ten years. Although no formal statistics exist tracking the life expectancy of those suffering from chronic pain, there are three main arguments that have been used in litigation involving CRPS.
CRPS may lead to a sedentary lifestyle, resulting in an increased Body Mass Index. Obesity is well known to lead to a shortened lifespan.
There is no statistic associated with suicide rates in the CRPS patient population, but it is well known for being one of the "suicide diseases." This affects the overall life expectancy for this patient population. In a few severe cases, the systemic systems associated with it may lead to death. For example, CRPS may cause cardiac dysfunction, autoimmune conditions, and GI dysfunction, ultimately incompatible with life.
CRPS is not a terminal illness. However, the consequences if left untreated can severely damage a patient's mental health and prognosis. CRPS has been referred to as a suicide disease. The symptoms caused by this condition can lead to depression, suicidal ideation, and other conditions that lead to death. This is one critical reason that patients must seek medical care as soon as possible for treatment. In addition, in a few severe cases, the systemic systems associated with it may lead to death. For example, CRPS may cause cardiac dysfunction, autoimmune conditions, and GI dysfunction, ultimately incompatible with life.
Spero Clinic's Neurologic Rehabilitation program has been shown to significantly improve patients' lives and help them go into remission. We believe that to truly heal, you must get to the root cause instead of merely treating the symptoms. Some patients make great strides by decreasing inflammation through diet and lifestyle changes, as well as using programs teaching them how to better manage any stress, as stress is the enemy of pain.
Traditionally, the allopathic community has been treating CRPS pain by prescribing pain medication such as opioids or inserting durable medical devices such as spinal cord stimulators and pain pumps. However, while this approach may sometimes work, the side effects are frequent and may be devastating to the patient, even life-threatening. It is also not a successful long-term approach. We believe that true pain relief comes with healing by rehabilitating the central nervous system so that the body may heal from within. This may be obtained through focused neurologic rehabilitation programs such as ours. We always say that medical pain intervention has a ceiling, pain does not.
Some patients make great strides by decreasing inflammation through diet and lifestyle changes, as well as using programs teaching them how to better manage any stress, as stress is the enemy of pain. We also recommend that the patient keeps moving as much as their body will allow. In chronic pain, every inch relinquished to a sedentary lifestyle is usually an inch lost.
Unfortunately, CRPS does not go away, but instead patients experience remission. Today, there are treatments available to help patients decrease pain, regain their mobility, and lead better lives. Dr. Katinka’s Spero Clinic offers a treatment plan that has shown to significantly improve the lives of the patients suffering from CRPS including:
Contact Dr. Katinka and The Spero Clinic today to learn more about CRPS and to get help.
Start your patient journey with the Spero Clinic's neurologic rehabilitation program.
