20. Complex regional pain syndrome (CRPS)
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- čas přidán 17. 07. 2024
- Lectures for pain specialist trainees preparing for their exams (FFPMANZCA, FFPMRCA), or anyone else that is interested. This lecture focuses on complex regional pain syndrome (CRPS).
Feel free to make comments or ask questions
PS. The elements of pain website has been closed. - Věda a technologie
Great presentation
I have CRPS from crushing injury to leg 1 yr ago. It is horrible to be treated like it is "all in your head" ... it's not. So many more symptoms and issues. Nobody listens. My life is a mess.
Make sure you get yourself to see a proper pain specialist physician. See them sooner rather than later because your CRPS is quite new and hence is likely to be managed more effectively
I was diagnose a yr ago i had a shoulder surgery, after 3 months my right hand was not moving the normal way, not only that it was so sensitive to the touch. So i told my family doctor my surgeon diagnose me with CRPS, what she said to me its all in my head. I ask whats happening to me till this day she said its all in my head, I felt so lonely still do cause im still learning different things happen to me every day. Half of the time i dont sleep this pain worst then labor pains almost like your burning alive.
@@yayazun389 ... I began counseling ..working on neuroplasticity. ... look into that type of therapy
czcams.com/video/oo5caGP5dAE/video.html
My daughter too. She has had it for a year, she is 14 now and suffering.
I am diagnosed with CRPS.Multiple surgeries post ankle surgery.Discharged,no aftercare.Hospital acquired injury,and trying to manage pain control myself.POP,gave me a pressure sore.
I've had CRPS since I was in my early 20's but did not receive a true DX till I was 28. I'm 39 now and it's really bad. I do ketamine therapy every 3-4 months' Lyrica which for me has helped with some of the burning. It feels like I am standing in cold snow so I can attest that LSB's work! It's the only procedure besides the ketamine that give me some warmth in my right leg. I also have it in my right elbow. But now I have no choice but to take pain medication but I take it as RX'd because the one I'm on finally after many trial and error have one that at least brings me down to a 3-4 on the pain scale. I'm usually an 8-9 but it's really can be worse than that. I am also on tricyclics which I feel helps as well. What I really appreciate the talk about the cold phase which is where I'm at. This disease can be hell but stay positive! Thank you for such a great lecture!
When I first started describing it I couldn't decide whether it was you pour gasoline on and lit my arms or if it was just extreme cold that are numb but unbelievably painful. it's the same feeling really.
Excellent vid
I have Complex Regional Pain Syndrome. I have broken my neck twice, my right ankle once and my right wrist once. I have had shrapnel injuries. None of these things cones close to the pain I feel with CRPS.
The closest pain to CRPS I've ever felt was when I was splashed with burning hot oil or when I accidentally got hot tar on my finger tips, it hurts more than either of those but it's a similar pain.
I was on 100 micron fentanyl patches but it was destroying the skin on my legs (the only part of my body that isn't oily, I am naturally very oily skinned so the patches won't stick) so I asked my doctor to be put on tablets, I wanted fentanyl tablets... my doctor put me back on Oxycontin 😪 a pain killer that didn't work in the beginning and definitely isn't working now. I suffer every day and I blame my doctors for it. I'm going to give her a couple of weeks more, after that I will give up on her and try to get back into the patches, if my GP refuses to put me back on the patches I will find a heroin dealer and take that, Fentanyl was the only thing that came close to helping, the dose I was on was equivalent to just over 400ml of morphine, apparently it's dangerous to be that high for so long, it can shorten my life expectancy but answer me this, which would you prefer:
1. Dead by the age of 50 (I am 38 or 39, can't remember as th last 10 years are a blur of pain) and experience a moderate daily pain but still be able to function slightly.
Or
2. Experience an horrifically intense pain every day, remain stationary for almost every hour of the pain. Consider and are close to suicide because of the pain (I actually looked at travelling to one of the euthanasia clinics but I can't afford the treatment.
I have 4 kids, I can't be a dad to them. My wife's life would be better/easier if I were dead. My life would be easier if I were dead. I am not a religious person but I do consider suicide to be for the weak minded. I wasn't weak minded before this fucking illness but I am now and it gets worse by the day. I hate myself, I hate what my family have to deal with.
To anyone else with CRPS: I hope you get better, I hope I do too but after more than 10 years of it, I don't see any way to get better as I have had this illness longer than the 12 to 18 months that my doctor says CRPS remains curable. Too much pain to cry, it makes me delirious.
MArtin. So sorry to hear your are suffering. In short: have you seem a qualified interventional pain specialist physician?
@@PainSpecialistsAustralia no, I haven't seen one of those. I live in England, it's not easy seeing specialist, i have been referred to the community mental health team... 6 months later and I still haven't had an appointment, I've given up hope of receiving the help I need.
@@madMARTYNmarsh1981 Seek out a pain specialist. Most public hospitals have pain management clinics
@@madMARTYNmarsh1981 Hi, I have CRPS too. It's in both of my feet and I'm pretty much stuck in bed. Im so sorry that your CRPS is so badly uncontrolled. I live my life at a 8-9 out of 10 every day. I have never had a fentanyl patch and never had a medicine that has helped me, yet. Have you tried the various surgical options like a weeks-long epidural ?( FYI I had RSD when I was 17 in my left knee; it lasted about 10 months and what put me in remission for 10years was a simple 6-week epidural that had fentanyl in it.)Some of the other types of treatment commonly used in the US are :
the DRG (a type of neuro stimulator that works upon your Dorsal Root Ganglion to stop the association between pain and that part of the body), a regular neural stimulator does something similar as the DRG; and the Intrathecal Pain Pump is also terrific at providing continuous pain meds delivered directly to your nerves.
I know that England must have a Pain Center somwhere...my pain doctor went to England to learn more about how to do the DRG surgery from experts there. There must a pain management doc there. I also take CBD oil. Im not sure if that is allowed in England, but it does help a bit. Take care!
Martyn James Ketamine infusions. Have you heard of ketamine infusions. All CRPS patients need a pain specialist.
My 14 year old daughter has suffered for a year. We live in Qld and treatment is limited.. very limited. Tramadol, anti inflammatory drugs and antidepressants have not done much. I was told that DMSO could help topically yet not available in Australia.. Her pain is spreading from her whole left arm up to her neck and face. I have asked about Ketamine and no ... not in Qld...! Because of my daughter’s age they won’t give her Opiates., other than Tramadol 50 mg 3 times a day. Celebrex twice daily. They are talking about a hospital stay as this pain and being an outpatient is not treating her quickly enough as driving to the hospital is too painful for her and appointments get missed. My daughter had a horrible reaction to Gabapentin, so that isn’t an option.
I’m having some success with hyperbaric chamber can you find one?
How is she nowdays
GABAPENTIN MADE ME HALLUCENTATE!!!!!!!!!!!!!!!!!!!!!!
@@isabella3025 my daughter is still in a bad way .. 😞
I was taking a cream that had Ketamine in it and now I can no longer get it Not at the price that I could afford anyway.
Hi Susan. DMSO is available from compound pharmacies in Australia. If she has not seen a pain specialist physician, she should. Our practice is based in Melbourne. It may be worth contacting us. Pain Specialists Australia.
I have used DSMO on my hands and it really works. Go to health food natural store and I ask for a strong one.
Thanks
I suffered from full body CRPS for 11 years. I have completely healed my body. The only way that I found was to completely detox off all meds and use physical activity to do so. It was difficult but it worked. Reach out if you have any questions. ❤️
I WANT YO KNOW MORE Im so frustrated 2 years now, can you please email me,thanks yosamsung@yahoo.com
How ? I was told that it’s chronic and progressive and that it will spread to the rest of my body. It effects my whole body including my heart and blood pressure causing my heart to drop too low or get to high and faints. When I have flare ups I go into temporary paralysis. I’m unable to work out unless it’s with my pt or ot because I have severe arthritis, hyper extension of -18 causing me to easily dislocate joints , tremors , weak bones and only half of the bone in my left arm from surgeries where I had to have it shaved twice and tubes running from my shoulder to my fingers protecting the nerves from being trapped again. If there’s anything you did can you please tell me so I can live a somewhat normal life.
She RAW I would love to know more about how you healed yourself. I know someone with CRPS who I am trying to help. Please contact me zen888@gmail.com
SheRAW didn't you have severe atrophy after 11 years of CRPS? If so, how did u exercise those areas and completely heal? I've had CRPS for 28 months now predominantly in right hand, elbow and arm (hand is most pained) and atrophy has greatly advanced. Hand is just bones. How do you gain muscle back in such an area? Or by "completely healed" do you specifically mean pain-free? email me if you would -- I'd love to know more about your reversal Katsegure@icloud.com Thankyou
What are the physical activities, please ?
What studies are being down to correlate gut health to brain health and the overall ability of the body to function and detox? Invasive procedures and drugs are not getting to the root of the problem. Tragically frustrating.
I had a 4th metacarple fracture and although the bone healed the pain continued. It is driving me nuts
Finally had this diagnosis secondary to nerve damage (brachial plexopathy). Was positively suicidal. Everybody told me it was only nerve regeneration and would not treat my pain. Got 95% recovery of both injuries with Sympathetic nerve blocks and rehab for a good two years. Eternally grateful to the md Silverstien of Philly, an internist that had GBS and resulting interest in nerve diseases and caught it right away after I suffered for months and surely would have killed myself. Thank God it was not too late. I understand that if not diagnosed, blocks might not work.
4 years ago I was suffering with CRPS and I have tried everything I could to heal myself, but it was all to no avail, until I saw a post on a health forum about an herbalist preparing herbal medicines to cure everything type of diseases. Including CRPS , at first I doubted it was real, but decided to give it a try, when I contacted this herbalist through his email and he prepared me a herbal cure for CRPS and sent it to me via the delivery service of UPS from the company, when I received this herbal cure. , gave me step by step instructions on how to apply it, when I applied it according to the instructions I was totally cured of this deadly disease within 1 months of use, I am now free from CRPS , all thanks to Dr. Joshua Ighalo. You can also contact this great herbalist for help by email: drjoshua.ighalo@gmail.com or contact Dr. through his whats-app: +2349057958723 They also specialize in the treatment of all kinds of diseases, VIRUS HERPES , HEPATITIS B, CANCER, BRAIN DISEASE, INFERTILITY, DIABETES AND MORE.
Initially started in my left leg from an accident, then spread to left hand and arm after surgery, now I’m both ears...it’s been a long journey
All the very best to you Sean.
Are the definitions/ criteria used in this talk still up-to-date?
Thank you very much for this great lecture!
pretty much still up to date. Budapest Criteris
@@PainSpecialistsAustralia Thank you very much!
I would like to say as someone with CRPS, the gaba drugs , lyrcia are good when they work but when the side affects kick in it is deadly , memory loss long and short term , caues my eyes not to be able to focus , ringing in the ears still there a year after I stopped taking it and dont forget it is a right bastard to come off you have to taper off it even with the horrendous side effects , i have tried many meds in the 5 years i have had it and opioids are the only thing that work to help me to function, forget about pain free that does not happen it is all about taking the smallest dose to be able to function, it is very hit and miss to what works in my case anyway. Forget any physical therapy the pain is just not worth it what works for me is isometrics, everyone is diffrent and no 2 ppl present the same so there is no one size fits all approach. I am on 20mgh of norspan and 5 mg oxy for breakthrough i have it in my left knee now it has spread to left leg , part of lower right leg and rh side of my head
I had very similar experience with lyrics. I became terribly depressed and ended up in a very dark place.
CRPS is an evotutionary development to preserve the core at expense of the extremities.
It why animals can chew their limbs off when caught in a trap.
It is simply damage to a nerve. There is no "Type 1" or "Type 2". There is simply damage to a nerve. The damage maybe so slight at first, thar the injury is ignored by the patient.
And I believe RSD is a better name as it highlights the Regional and SYMPATHETIC nature of the pain.
Chronic Regional Pain Syndrome is so ambiguous. The diagnosis doesn't describe what is seen clinically.
Ive taken high dose opioids with minimal benefit.
High dose PREDNISONE(60mg/day) is what helps me. And oddly, I don't seem to have the high prednisone side effects: thinning of nails, elevated B.S., flushing of face.
As an anesthetist, I'd find it all fascinating, except it's happening to me.
First of all, you don’t even have the name of the disease correct and it doesn’t sound like you have a PhD so, please stop spewing nonsense. The nature of the disease is that there is no nerve damage and that’s what makes it so peculiar. Opiates don’t actually do anything for nerve pain, I have crps and they’re not prescribed because it doesn’t actually do anything they said . Irregular pain responses in the nervous system and nerve damage are different.
Prednisone is terrible for you.
The side effects are deadly
It doesn't always burn as a primary symptom. I have some burning but it's not my first complaint.
Agree Julie. Best of luck
@Dani Reme how long have you had this going on?
I can't get diagnosed with it. No one know here in Canada recognizes it. All my doctor did was a nerve conduction test and then said I don't have it. I've been in a pain clinic for a year, and they are calling it chronic pain in my leg and foot. Im so mad. I definitely have it.
If Infliximab/remicade works, has there been any research with Enbrel, also TNF blocker/inhibitor? Any connection with CRPS and Rheumatoid Arthritis? Is CRPS considered an inflammatory autoimmune disease? Is Raynoud's Phenomenon associated with CRPS? Hashimotos's I have moderate-severe RA, but at onset in 2004 at age 49 presented with rapid onset of rare neurology pain and twitching and very severe migratory burning nerve pain, raynounds disease and body wide Allodynia. Mayo neurologist DX mononeuritis multiplex from autoimmune disease, thyroid or RA (?). After a few years of toxic meds, methotraxate and allergic rxn to sulfasazine that almost burst my gut in a toxic megacolon. In 2006, docs finally got me on Enbreal and 6 months later much of the nerve pain, Allodynia and conus twitching went away. Now only high stress or extreme pain brings on the twitching of hands and legs anymore. But in 2016, had severe complications immediately after a left knee replacement of red hot swelling and extreme burning pain. Ortho knee doc thought it was infection, but blood work showed inflammatory response so we assumed it was RA attacking the new parts, but I question if maybe a CRPS component???. Now I am very concerned I may have CRPS as I am 4 weeks out of a major hammertoe surgery with long pins in three toes. I have been having increasing burning, throbbing, stabbing electric shock like pain since the surgery. I have the twitch of hands, arms, legs and feet back and extreme allodynia on the forefoot of the left foot with the hammertoe surgery. GP doc put me on Gabapentin which I am needing more and more to help control the burning pain. Comes on fast for no reason and can last 12 hours or more till it settles out for 3-8 hours then another bout of pain, nights can be unbearable and have to take vicodin and gabby. Ice makes it worse and triggers the nerve pain. Ortho doc is not acknowledging my pain, probably thinks I am over reacting or wanting narcotics I still have 2 more weeks of the K wires in my 3 toes and very worried. I need a good neurologist or pain doc in Colorado please that can make a DX and help sort this out.. I have been through dozens of surgeries, major back TLIF fusion, 6 knee, hands, feet etc, but nothing touches this quality of pain I have now and it is worsening every day. Thank you for any help for some direction and excuse my spelling!
Not sure if you've got CRPS but should should definitely be seeing a board certified pain specialist
@@nickchristelis8852 I understand I need real DX, not a Utube or patient DX.I told my ortho doc, I was having burning shock like nerve pain and he said normally neuropathic pain is numbness, so that is what I am up against with convincing my ortho doc I am experiencing extreme neuro pain. I am seeing my rheumatologist on Tuesday and will see what she thinks. Problem I will have is closest doc will be Denver, a 7 hour drive across I70 one way. Maybe more likely an entrapped nerve, but this is 3rd time for last 3 major surgeries that I have had complicated neurology issues docs cannot figure out and they just give me prednisone, which does help. I have intense bone crushing/piercing tearful burning and electric shock like pain that comes and go in daily patterns, night and day. GP doc scribed 1200mg gaba and vicodin to take edge off enough to get by. I have myoclonic twitch of arms/legs, allodynia on forefoot post surgery 4 weeks ago. Subjectively, increased hair growth bilateral legs. I am mid 60's, female, complex med history including asthma/allergies and multiple AI diseases. I know I need a qualified doc for DX, but know it will be a tough journey to even get to one and certainly out of question now with pins in toes. I have noticed my worst neuro pains correlate with times of low pressure when fronts are moving in, but that happens with RA/OA as well. I know these complicated diseases can cluster and overlap, so wondering about possible RA and CRPS connection, but seeing anything like that is google searches? Thanks much!
Marcia Ewell enbrel side effects caused my daughters CRPS.
extremely good questions
Hi there is there any evidence of PRP treatment for patients with CRPS that it helps with pain management ?
PRP doesn't help CRPS Arthur
Don't tell ME those blocks didn't work.
Do people go on disability for this?
you forgot one treatment, diet. A whole food plant base diet
yes thank you,
Don't dare talk like that. You're a political activist who couldn't care less about real people. Shame on you. I hope you suffer this for just one day.
It's a curse from Yah
Jason Heal wrong
You guys find this funny?
I hope you feel it for just one day.