As a patient with CRPS, I can tell you the prognosis is not very good. This is a progressive disorder. At the present time there is no cure. This is a very complex disorder that very few doctors really know how to treat. It is also more than just a chronic pain disorder, the effects are far reaching. The best information will come from these websites: RSDhope.org, RSDS.org, RSDFoundation and rsdrx.com. These sites deal only with RSD/CRPS.
I am not sure why they are not willing to do nerve blocks. Many of us receive lumbar blocks. I will tell you that not everyone is helped by nerve blocks.
The following information about making a diagnosis comes from the RSD Foundation .org website.
Making the Diagnosis of RSD / CRPS
The diagnosis of RSD / CRPS can be made in the following context. A history of trauma to the affected area associated with pain that is disproportionate to the inciting event plus evidence at some time for one or more of the following:
Abnormal function of the sympathetic nervous system, e.g., abnormal changes in skin blood flow, sweating or goose flesh.
Swelling.
Movement disorder.
Changes in tissue growth (dystrophy and atrophy).
Thus patients do not have to meet all of the clinical manifestations listed above to make the diagnosis of RSD / CRPS. Note also that the criteria state "evidence at some time" for the clinical findings. This does not mean that the evidence for the clinical finding listed has to be constant. This explains why swelling, abnormal sweating, abnormal skin temperatures, etc., are not reported by the physician on some visits. Sometimes weather plays a factor or emotional stress or the patient may be in a flare-up or a remission stage. Patients have good and bad days.
The RSD / CRPS diagnosis is precluded by the existence of known pathology that can be explained by the observed symptoms and degree of pain. The pain and symptoms of RSD / CRPS may exceed both the magnitude and duration of symptoms expected from the normal healing process anticipated from the inciting event. There seems to be a small group of patients whose pain following trauma resolves over time, leaving the patient with more of a movement than a pain disorder. There are "grades" of this syndrome described in the literature with symptoms ranging from minor to severe.
Laboratory Diagnostic Aids:
There is no laboratory test that can stand alone as proof of RSD / CRPS. However, there are a couple of tests (thermogram and bone scan) which can be useful in providing evidence for RSD / CRPS.
Thermogram - A thermogram is a noninvasive means of measuring heat emission from the body surface using a special infrared video camera. It is one of the most widely used tests in suspected cases of RSD / CRPS. As noted, detecting an abnormal change in skin temperature in RSD / CRPS depends on many factors. A normal thermogram does not necessarily mean the patient does not have RSD / CRPS. An abnormal thermogram may be helpful when there are minimal objective findings for RSD / CRPS documented in the medical record. Furthermore, certain patterns of abnormal heat emission from the body (e.g. circumferential versus dermatomal changes) are more indicative of the existence of RSD / CRPS than others. The thermogram should be performed at a reputable medical facility. The quality of the test may vary among providers.
Three phase radionuclide bone scanning - the role of the 3 phase bone scan in the diagnosis of RSD / CRPS has been debated and is controversial.
Sympathetic blocks - See below under "sympathetic blocks".
X-rays, EMG, Nerve Conduction Studies, CAT scan and MRI studies - All of these tests may be normal in RSD / CRPS. These studies may help to identify other possible causes of pain; for example, RSD / CRPS plus a carpal tunnel syndrome.
( http://rsdfoundation.org/en/en_clinical_practice_guidelines.html#DIAGNOSIS )
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As a patient with CRPS, I can tell you the prognosis is not very good. This is a progressive disorder. At the present time there is no cure. This is a very complex disorder that very few doctors really know how to treat. It is also more than just a chronic pain disorder, the effects are far reaching. The best information will come from these websites: RSDhope.org, RSDS.org, RSDFoundation and rsdrx.com. These sites deal only with RSD/CRPS.
I am not sure why they are not willing to do nerve blocks. Many of us receive lumbar blocks. I will tell you that not everyone is helped by nerve blocks.
The following information about making a diagnosis comes from the RSD Foundation .org website.
Making the Diagnosis of RSD / CRPS
The diagnosis of RSD / CRPS can be made in the following context. A history of trauma to the affected area associated with pain that is disproportionate to the inciting event plus evidence at some time for one or more of the following:
Abnormal function of the sympathetic nervous system, e.g., abnormal changes in skin blood flow, sweating or goose flesh.
Swelling.
Movement disorder.
Changes in tissue growth (dystrophy and atrophy).
Thus patients do not have to meet all of the clinical manifestations listed above to make the diagnosis of RSD / CRPS. Note also that the criteria state "evidence at some time" for the clinical findings. This does not mean that the evidence for the clinical finding listed has to be constant. This explains why swelling, abnormal sweating, abnormal skin temperatures, etc., are not reported by the physician on some visits. Sometimes weather plays a factor or emotional stress or the patient may be in a flare-up or a remission stage. Patients have good and bad days.
The RSD / CRPS diagnosis is precluded by the existence of known pathology that can be explained by the observed symptoms and degree of pain. The pain and symptoms of RSD / CRPS may exceed both the magnitude and duration of symptoms expected from the normal healing process anticipated from the inciting event. There seems to be a small group of patients whose pain following trauma resolves over time, leaving the patient with more of a movement than a pain disorder. There are "grades" of this syndrome described in the literature with symptoms ranging from minor to severe.
Laboratory Diagnostic Aids:
There is no laboratory test that can stand alone as proof of RSD / CRPS. However, there are a couple of tests (thermogram and bone scan) which can be useful in providing evidence for RSD / CRPS.
Thermogram - A thermogram is a noninvasive means of measuring heat emission from the body surface using a special infrared video camera. It is one of the most widely used tests in suspected cases of RSD / CRPS. As noted, detecting an abnormal change in skin temperature in RSD / CRPS depends on many factors. A normal thermogram does not necessarily mean the patient does not have RSD / CRPS. An abnormal thermogram may be helpful when there are minimal objective findings for RSD / CRPS documented in the medical record. Furthermore, certain patterns of abnormal heat emission from the body (e.g. circumferential versus dermatomal changes) are more indicative of the existence of RSD / CRPS than others. The thermogram should be performed at a reputable medical facility. The quality of the test may vary among providers.
Three phase radionuclide bone scanning - the role of the 3 phase bone scan in the diagnosis of RSD / CRPS has been debated and is controversial.
Sympathetic blocks - See below under "sympathetic blocks".
X-rays, EMG, Nerve Conduction Studies, CAT scan and MRI studies - All of these tests may be normal in RSD / CRPS. These studies may help to identify other possible causes of pain; for example, RSD / CRPS plus a carpal tunnel syndrome.
June 30, 2011 - 9:54pm( http://rsdfoundation.org/en/en_clinical_practice_guidelines.html#DIAGNOSIS )
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