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Monday, May 27, 2013

Integrated Solutions to CRPS Conference Notes (Part III)

Integrated Solutions to CRPS 

May 10, 2013

 San Francisco, California

This was a great conference on CRPS and I recommend to those suffering to familiarize yourself with their website. This is Part III of my notes from this conference. 

Always try Neurontin and Lyrica first in attempt to control the symptoms. This process can take awhile with gradually weaning on and off these medications to check their effectiveness. 
Based on your response to Neurontin/Lyrica, you can add or switch to Cymbalta or Savella.
Cymbalta and Savella block the pain signals going from the spinal cord to the extremity, with the presenter liking Savella best (Savella tends to need an anti-nausea drug and an anti-headache drug in combo). I personnally prefer Cymbalta.

Exercise and PT are crucial, must do daily with the Goal of Restoring Function---there is a fine balance between honoring the pain and ignoring the pain. 
Full Immobilization increases RSD symptoms and should be avoided--however there are many ways to protect, slightly immobilize, and then allow function
PT Goals are to  Restore function and learn how to properly adjust limb movements
   Avoid hurting
PT with a new RSD onset must stay below pain level, varies day to day
PT with a Chronic RSD must be more about restoring function 
Time focused PT---at times avoid pain, at times push through pain

Marketed in Europe
Marketed as Normast or PeaPure
Used for Neuropathic pain

Presently being experimented with

DMSO 50% successful if applied with other topicals 5 times day
Better affect in warm RSD
Must get 99.9% purity

NAC is an Antioxidant
It is better used in Cold RSD

Use Vitamin C 500mg for 45 days, and with flares

I have attached below an email from a patient actively looking for help with her CRPS. I provided the checklist and she outlined all of the treatments she was working with. It takes a tremendous effort to gain back your life. The notes from this conference as I retype constantly remind me how little I know, but definitely the medical world and those who are suffering are being to find answers.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.