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Friday, May 30, 2014

Complex Regional Pain Syndrome: Email thoughts on possible/present treatments

This is an email I sent a patient, whom I just met, with 14 months of CRPS. The neural prolotherapy from Dr Lee Wolfer as described in my last post is helping greatly. She still has metatarsal pain so I am making soft Hannaford orthotics and sent her some of my other thoughts below. 

First of all Sally (name changed), it was a pleasure to meet you. Here are 2 links from my blog I would like you to see. 

My general thoughts for now and in the future:
  1. Continue with the Wonderful Dr Wolfer and neural prolotherapy
  2. See if Dr Wolfer will look into Calmare Pain Therapy
  3. Consider adding low dose naltrexone 1-4.5mg/day
  4. Have an Rx for sublingual Ketamine for flares if occur
  5. Purchase Neuro-Eze and apply topically 3x/day
  6. Get Hannaford orthotics for protected weight bearing
  7. Continue Gabapentin/Cymbalta/Atavan for nerve stabilization
  8. Start daily Graded Motor Imagery with laterality flashcards and Mirror therapy
  9. Remember PT and exercise are crucial, PT you must start an exercise below pain level, and very gradually increase to restore lost function
  10. May consider 50%DMSO cream (99.9% Pure) with other topicals
  11. Vit C 500mg x 45 days or with flares
  12. 30 min to 1 hour meditation per day
  13. We await reading of the MRI CD
  14. Consider sleeping with Lidoderm patches
  15. Check Vit D3 level, make sure it is at 45-50
  16. Consider Somatic Experiencing (decreases sympathetic response)
  17. Consider gluten free diet, emphasize fresh whole foods, de-emphasize highly processed foods.
  18. Do Neural Flossing 3 times per day
  19. Increase Cardio--stat bike with weight on non painful area (like arch or heel). Exercise decreases glial inflammation. 
Hope this helps. Rich

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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.