About the notation CRPS (RSD)
CRPS is an abbreviation for Complex Regional Pain Syndrome, and RSD is an abbreviation for Reflex sympathetic dystrophy.
The reason why this society uses the notation of CRPS (RSD) is that before the International Society for Pain (IASP) established the diagnosis name of CRPS, the old disease name "RSD" was used for a long time in clinical practice and is still used today. Because it can be done.
Historically, the burning pain that occurred after peripheral nerve injury was called causalgia. It is now called reflex sympathetic dystrophy (RSD) because of tissue atrophy caused by
BReIN
Later, however, it was found that sympathetic nerve problems were not always present, and a group of diseases with similar symptoms came to be collectively called "CRPS."
historical background
| 1864 | During the American Civil War, Mitchell and others first discovered "causalgia". Causalgia is a portmanteau of two Greek words, Kausis (=burning) and algos (=pain). |
| 1900 | Sudeck published acute bone atrophy after trauma. |
| 1946 | Evans finds sympathetic involvement and announces reflex sympathetic dystrophy (RSD). |
| 1947 | Steinbrocker announces shoulder-hand syndrome. |
| 1953 | Bonica classifies peripheral similar diseases. They are collectively referred to as RSD. |
| 1977 | Lankford is classified into 5 categories for easy understanding. |
| 1986 | The World Society for Pain (IASP) distinguishes between RSD and causalgia. |
| 1990 | Kozin publishes clinical diagnostic criteria for RSD. |
| 1994 | The World Society for Pain (IASP) announces a new classification. RSD is type 1 of Complex regional pain syndrome (CRPS), and Causalgi is named type 2. |
| 1994 | Bach-y-Rita presents the concept of NDN. He explained that the cause of pain in RSD is up-regulation of receptors in the brain nerve cell membrane. * NDN is an abbreviation for nonsynaptic diffusion neurotransmission.⇒ Click here for details.. |
| Year 2005 | Mikami (the author) translated "receptor up-regulation in NDN" into "activation of the pain center", and in RSD it is necessary to consider "pain" and "sympathetic nerves" separately. , presented the concept that ``activation of the pain center'' and ``sympathetic nerve dysfunction'' happen to occur simultaneously or with some kind of correlated reaction, occurring at the same time or with a time lag. |
clinical symptoms
Pain at rest Pain during exercise Burning pain Redness Heat sensation Swelling Edema Nail change Loss of skin line Glossy skin Bone atrophy Muscle atrophy Allodynia: a stimulus that normally does not cause pain induced pain), hyperalgesia (hyperalgesia), Raynaud's phenomenon, coldness, pale skin, hyperhidrosis, hirsutism, hair loss, joint contractures, stiffness, other
Onset trigger
[Trauma] Fractures, bruises, sprains, dislocations, contusions, cuts, puncture wounds, etc.
[Disease] Chronic pain in the trunk of the limbs, myocardial infarction, diabetes, disc herniation, cervical degenerative disease, cerebrovascular disease, nerve axon tumor, poliomyelitis, multiple sclerosis, rheumatoid arthritis, osteoarthritis, etc.
[Iatrogenicity] Finger amputation, hand tumor resection, violent manual reduction, gypsum binding, myelography, passive compulsory exercise therapy, correction by chiropractic, bodywork, etc., strong stimulation physiotherapy, pessimistic muntera, intense massage and acupressure, accidental needle sticks to the median and sciatic nerves, intraneural or paraneural injections of thiopental or alcohol, surgery in general, and other immature pain management in disease and immature swelling control in trauma
Treatment
[Pharmacotherapy] (1) Steroids (2) Antidepressants (3) Neurotropin (4) Kampo medicines (5) Ketamine (6) Sympatholytic (Guanethidine) (7) Lyrica Tramset
[Surgical treatment] ① Sympathetic ganglionectomy ② Nerve resection, nerve ablation ③ Neurobone immersion ④ Epidural spinal cord stimulation ⑤ Deep brain stimulation (DBS)
[Block therapy] (1) stellate ganglion block (2) epidural block (3) sympathetic nerve block (IRSB) (4) lumbar sympathetic nerve block (5) focal nerve block
[Conservative therapy/Non-invasive treatment/Others] 1. Hot and cold alternating bath 2. Elevation of the affected limb 3. Transcutaneous electrical nerve stimulation (TENS) 4. AKA 5. Psychological approach 6. Orthotic therapy 7. BReIN (including mirror therapy), etc.
taxonomy concept
*The perspective of being divided into complete type and incomplete type: This is the classification by this society. As a trend in recent years, there is an impression that the incomplete type is overwhelmingly more common. If you have a defective type that is not complicated by mental illness, BReIN will definitely recover. For that exampleThis page "CRPS (RSD) improvement cases"is introduced.
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