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What Causes Reflex Sympathetic Dystrophy?

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Posted on Wed, 29 Apr 2015
Question: I have 'Reflex Sympathetic Dystrophy' (RSDS/CRPS) following ulnar nerve surgery in 1991 on my left elbow. I have been in constant pain since then and have been taking morphine. I would like to know what other meds would be effective for RSD pain..
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Surgery can be beneficial

Detailed Answer:
I read your question carefully and I am sorry for the pain your are in. Reflex Sympathetic Dystrophy has always been and remains a challenge to treat.

Apart from the drugs which you are already taking the medication which are tried usually are antidepressants (amitriptyline, duloxetine) or anticonvulsants (gabapentine,pregabaline). Actually you already take an anticonvulsant like Zonegran but that is not that proven for this indication, its use is not approved for pain. You don't mention nonsteroidal anti-inflammatory drugs,but surely they have been tried at the beginning.
Also treatment with Clonidine patch may also have some modest benefit.

There is also surgery which includes sympathectomy, removing sympathetic ganglions (usually reserved for patients who have had some success with sympathic drug blockade). Another option is spinal cord stimulation after the insertion of an epidural implantation.

These are the other available options. I hope to have given you some new options, although given your long history of trying several pain clinics you probably have already tried some of these options.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Causes Reflex Sympathetic Dystrophy?

Brief Answer: Surgery can be beneficial Detailed Answer: I read your question carefully and I am sorry for the pain your are in. Reflex Sympathetic Dystrophy has always been and remains a challenge to treat. Apart from the drugs which you are already taking the medication which are tried usually are antidepressants (amitriptyline, duloxetine) or anticonvulsants (gabapentine,pregabaline). Actually you already take an anticonvulsant like Zonegran but that is not that proven for this indication, its use is not approved for pain. You don't mention nonsteroidal anti-inflammatory drugs,but surely they have been tried at the beginning. Also treatment with Clonidine patch may also have some modest benefit. There is also surgery which includes sympathectomy, removing sympathetic ganglions (usually reserved for patients who have had some success with sympathic drug blockade). Another option is spinal cord stimulation after the insertion of an epidural implantation. These are the other available options. I hope to have given you some new options, although given your long history of trying several pain clinics you probably have already tried some of these options. I remain at your disposal for further questions.