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DISEASE AWARENESS PAGE FOR R3 STEM CELL – CRPS AND RSD

COMPLEX REGIONAL PAIN SYNDROME/REFLEX SYMPATHETIC DYSTROPHY

What is It?

Complex Regional Pain Syndrome or CRPS, formerly referred to as Reflex Sympathetic Dystrophy is a condition of chronic pain that is usually centered around a leg or an arm.

 

CRPS is known to develop after the body has undergone trauma such as an injury, a stroke, a heart attack or a surgery.

 

It is not known exactly what causes CRPS although it is generally considered that it can be caused by an abnormality in the peripheral and central nervous system, sometimes resulting from an injury or trauma of some sort.

 

The pain felt because of the condition is much higher than that of the injury itself.

 

Complex regional pain syndrome manifests itself in one of two types. Type 1 is also known as reflex sympathetic dystrophy syndrome, RSD, which is the type nearly 90 percent of CRPS patients suffer from.

 

RSD begins after the patient is struck by an illness or injury that did not cause direct damage to the nerves.

 

Type 2 is called causalgia and results from a direct and definitive injury to the nerves. Both types exhibit similar symptoms.

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HOW COMMON IS IT AND WHO IS AT RISK?

Complex regional pain syndrome can occur at any age but of the known cases, the disease develops most between the ages of 40 and 60. Females, more specifically, females of postmenopausal age, are more likely to develop CRPS more often than males. Studies are still inconclusive about exactly who is more susceptible to the disease and what the particular risk factors are but some frequent injuries leading to CRPS are a fracture of the distal radius, ankle dislocation, and an intra-articular fracture.

 

Other potentially at risk are those that feel the pain of notably higher levels than normal during the early stages after the trauma has occurred. However, these factors do not account for all cases and many individuals presenting these issues do not develop complex regional pain syndrome.

WHAT ARE THE SYMPTOMS?

Symptoms of this condition are known to vary from one case to another. However, the most initial and definitive symptom is a pain. The severity of the pain, of course, is not the same for all of those affected. This is usually accompanied by swelling and redness in the affected limb. The pain can feel like a burning or throbbing sensation. A hypersensitivity to temperature, hot or cold is also common.

 

Other symptoms include changes in skin texture, color or temperature. The limb can go from looking white to either blue or red. The skin may also become tender and inflamed. Other changes can include abnormalities in nail and hair growth. Joints in the limb could become stiff and muscle spasms and tremor could occur along with the weakness and decreased movement in the injured limb. Once the limb starts to look pale and muscle spasms and tightening occur, the condition has probably become irreversible. 

 

Conditions of complex regional pain syndrome may sometimes spread to other parts of the body, commonly to the opposite limb. In some cases, the symptoms may disappear after a while but may remain consistent for several months to years. 

HOW IS IT DIAGNOSED?

Diagnosis for complex regional pain syndrome is started with a physical examination during which the doctor will evaluate the physical symptoms. The doctor may press down on different points in the limb to check for tenderness or move the limb in different directions to evaluate the range of motion and condition of the joints. A medical history of the patient is also required to determine the trauma that may have led to the development of the condition. 

 

Although no single test can completely diagnose CRPS, many different ones can be conducted to effectively judge symptoms and come to a conclusion. Bone scans help in determining if and where changes have occurred in the bone. The scan is done by injecting a radioactive substance into the veins so that they may be visible under a special camera. Sympathetic nervous system tests determine abnormalities in the sympathetic nervous system. One of these is thermography, which checks the temperature and blood flow to the limbs. If the blood flow is uneven in the affected and unaffected limbs it may signal CRPS. 

 

If diagnosed in the later stages, X-rays can show a loss of minerals from the bone. Other imaging tests like magnetic resonance imaging or MRI scans can help in determining changes to the tissues.

WHAT ARE THE TREATMENT OPTIONS AVAILABLE?

There is no cure for complex regional pain syndrome, as of now, but a combination of different treatments together can significantly help in controlling the symptoms. Treatments are most effective if started within the first few months when symptoms begin showing up. Treatment combinations are devised on a case to case basis, depending on the type of symptoms and their severity.

 

Various medications are available to manage symptoms of CRPS. For the mildest cases, over the counter pain relief medicines like ibuprofen could suffice in treating the pain. Opioids might be prescribed for more severe cases for a limited time under proper supervision by the physician. Some antidepressants can ease neuropathic pain. For some individuals, corticosteroids may be prescribed for a time to reduce inflammation in the limb. Other medications include bone-loss medication and sympathetic nerve-blocking medication. Some studies have also come out in favor of intravenous ketamine for pain relief. 

 

Doctors may recommend different types of therapies to cope with the pain and other symptoms. Application of heat or some topical treatments like lidocaine cream can relieve pain, swelling, and hypersensitivity. Mirror therapy is used to trick the brain into improving the functions of the affected limb. The patient is made to sit before a mirror and move the healthy limb, which the brain perceives as the movement of the injured limb. 

 

Physical therapy is an important treatment for CRPS. A physical therapist guides the patient through exercising the affected limb to relieve pain, improve range of motion, increase flexibility, endurance, and overall strength. Physical therapy produces much better results if the diagnosis is made in the earlier months of the disease developing.

 

Other types of therapies are transcutaneous electrical nerve stimulations to reduce pain by applying electrical pulses to the nerve endings, and spinal cord stimulation to ease pain by passing current to the spine. Intrathecal drug pumps involve pumping pain relief medications directly into the spinal fluid. Biofeedback is also an effective form of therapy. Learning biofeedback techniques allow the patient to become more aware and in control of their own body to be able to relieve pain by relaxing their body at will.

 

Living with a chronic disease can impact a person’s mental health as well. It is not uncommon to go through frequent spells of restlessness, anger, frustration. Ways to minimize the impact are to maintain a daily routine as well as possible, get a healthy amount of rest every night, keep regular contact with friends and family and pursue, as best as one can, passions, interests, and hobbies. If the negative emotions and depressing thoughts remain persistent, it is vital to consult with a doctor or a therapist to get proper, professional help. Regular sessions with a licensed therapist or taking prescribed amounts of antidepressants can vastly improve the patient’s mental health and quality of life.

Here are answers to many of the frequently asked questions we receive.

TYPES

Arthritis can be classified into several types. Osteoarthritis is caused by the normal aging process of the body, or could be a result of injury.

Rheumatoid arthritis, the most common type of arthritis, happens due to autoimmune problems, wherein the body’s own immune system attacks healthy cells of the body. Infectious arthritis is caused by an infection to the joint. Patients with psoriasis may be affected by Psoriatic arthritis. Finally, excessive uric acid in the body can cause Gout, an arthritis that often starts at the toe.

RHEUMATOID ARTHRITIS

 

What is it?

Rheumatoid arthritis is an inflammatory form of arthritis. This disease causes chronic inflammation of the joints and can lead to deterioration of a variety of systems in the body. Rheumatoid arthritis occurs when the immune system attacks the lining of the membrane around the joints known as the synovium, which causes inflammation that thickens the synovium and ultimately deforms the cartilage and bone of the joints.

 

How common is it and who is at risk?

An estimated one percent of the entire world population suffers from rheumatoid arthritis. As the case with osteoarthritis, women are more likely to develop rheumatoid arthritis. Other groups at risk are people middle-aged or older as well as those suffering from obesity. Rheumatoid arthritis risk is inheritable, which may be accelerated by smoking or unknown environmental exposures.

 

What are the symptoms?

Signs of the disease include swollen, tender joints that may feel stiff, particularly in the mornings. Fever, fatigue, and loss of activity are also common symptoms. Rheumatoid arthritis tends to manifest initially in the smaller joints like those in the fingers and toes. Symptoms are exhibited in joints of other body parts as the disease spreads.

 

How is it diagnosed?

Diagnosis begins with a physical test checking for redness, warmth, and swelling as well as the state of reflexes in the affected joints. Multiple blood tests are conducted as people with rheumatoid arthritis usually have elevated erythrocyte sedimentation rates and C-reactive protein levels. Additionally, X-rays, MRIs, and ultrasounds are conducted to track the spread of the disease.

 

What are the treatment options available?

While no cure exists as of now, research has revealed that the symptoms may be controlled by early application of disease modifying anti-rheumatic drugs (DMARDs). Steroids or nonsteroidal anti-inflammatory drugs may be prescribed depending on the case. Exercises to retain joint flexibility also provide some relief. If medications fail to slow down the disease, doctors may recommend surgery to repair or replace joints or swollen tendons.

RHEUMATOID ARTHRITIS

 

What is it?

Rheumatoid arthritis is an inflammatory form of arthritis. This disease causes chronic inflammation of the joints and can lead to deterioration of a variety of systems in the body. Rheumatoid arthritis occurs when the immune system attacks the lining of the membrane around the joints known as the synovium, which causes inflammation that thickens the synovium and ultimately deforms the cartilage and bone of the joints.

 

How common is it and who is at risk?

An estimated one percent of the entire world population suffers from rheumatoid arthritis. As the case with osteoarthritis, women are more likely to develop rheumatoid arthritis. Other groups at risk are people middle-aged or older as well as those suffering from obesity. Rheumatoid arthritis risk is inheritable, which may be accelerated by smoking or unknown environmental exposures.

 

What are the symptoms?

Signs of the disease include swollen, tender joints that may feel stiff, particularly in the mornings. Fever, fatigue, and loss of activity are also common symptoms. Rheumatoid arthritis tends to manifest initially in the smaller joints like those in the fingers and toes. Symptoms are exhibited in joints of other body parts as the disease spreads.

 

How is it diagnosed?

Diagnosis begins with a physical test checking for redness, warmth, and swelling as well as the state of reflexes in the affected joints. Multiple blood tests are conducted as people with rheumatoid arthritis usually have elevated erythrocyte sedimentation rates and C-reactive protein levels. Additionally, X-rays, MRIs, and ultrasounds are conducted to track the spread of the disease.

 

What are the treatment options available?

While no cure exists as of now, research has revealed that the symptoms may be controlled by early application of disease modifying anti-rheumatic drugs (DMARDs). Steroids or nonsteroidal anti-inflammatory drugs may be prescribed depending on the case. Exercises to retain joint flexibility also provide some relief. If medications fail to slow down the disease, doctors may recommend surgery to repair or replace joints or swollen tendons.

JUVENILE IDIOPATHIC ARTHRITIS

Arthritis Stem Cell Therapy

What is it?

Juvenile Idiopathic Arthritis (JIA) is the most prevalent form of arthritis within kids. It is characterized by persistent pain, swelling, and stiffness in the joints. The disease occurs when the body’s own tissues are attacked by its cells. In some cases, it can create more serious complications such as growth problems and eye inflammation.

 

How common is it and who is at risk?

It is the most common form of arthritis diagnosed in children under the age of sixteen. Certain gene mutations can make the body more vulnerable to the external environment, which can result in Juvenile Idiopathic Arthritis occurring. Although reasons are unknown, girls are more susceptible to Juvenile Idiopathic Arthritis than boys.

 

What are the symptoms?

Commonplace symptoms include joint pain or a limp caused by the pain, swelling of joints and stiffness of the joints that results in clumsiness by the child. In some cases, the disease can manifest as high fever and rashes.

 

How is it diagnosed?

Diagnosis for Juvenile Idiopathic Arthritis is difficult as the pain and swelling in the joints could be attributed to a number of diseases. Quite a few blood tests are conducted to determine the status of markers like erythrocyte sedimentation rate, C-reactive protein levels, and quantity of anti-nuclear bodies, among others. However, many children with Juvenile Idiopathic Arthritis show no abnormalities in these tests.

 

What are the treatment options available?

The treatment for Juvenile Idiopathic Arthritis is geared towards making sure the child can maintain a regular level of physical activity. This can include different types of medication like nonsteroidal anti-inflammatory drugs to reduce pain and swelling or disease modifying anti-rheumatic drugs in more severe cases. Biologic agents may be recommended to help prevent joint damage. Physical therapy can also help the child maintain a full range of motion with or without joint supports or splints based on the situation. Surgery is the most extreme option used to improve the position of the affected joint.

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