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complex regional pain syndrome
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been diagnosed with crps, taken 2 years and a specialist hand surgeon to get a diagnosis. Anyone else got any tips ect. will start pain clinic in december. Also now severe depression with severe anxity.
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Well you are in good company
Welcome aboard 
Are you being treated for the depression?
Wanna talk about it?This is a reply to this message.
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Cheers, it's so wierd, under treatment of phychitrist and fab cmht nurse. My CRPS is in my right arm, do you just get us use to it. The pain is so diferent.
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You have just got to live with it " the words are easy but the music is hard" you seem to be getting some support though which should help. All the best for the future.
Cheers Tommy
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The following might help,extracted from another site
Dr Trisha Macnair responds
It sounds to me like your wife has what's known as complex regional pain syndrome (CRPS, also known as reflex sympathetic dystrophy). But there are other possibilities, related to nerve damage which has resulted from her diabetes , or even to her heart bypass operation, so make sure that these possibilities have been considered.
Complex regional pain syndrome is a chronic pain condition which develops after an injury, and continues after the injury has healed. The injury is often a small one (just like your wife's blood-test episode) that people would expect to quickly recover from. We still don’t understand exactly what causes the condition, or why the pain that develops is so out of proportion to the trauma that starts it.
Although we've learned a lot about pain in recent years, much still needs to be explained. In CRPS It may be that the 'memory' of the pain is stored abnormally in the brain (so efforts directed at her arm, where the pain started, are a waste of time). Alternatively, there may be some sort of damage to the nerve or abnormality in the nerve 'wiring' systems between the arm and the brain - we just don't understand how CRPS develops.
If it's CRPS, she'll need expert help to deal with it. Chronic pain of any sort is a misery for not only the sufferer, whose personality can be shattered by the problem, but also their family and friends, on whom it can take a terrible toll. Stick in there and give your wife all the support you can. There is hope that treatment will restore her to her old self.
Talk to your GP about referring your wife to the local pain specialist (often an anaesthetist in your local hospital). Or if you're lucky enough to live near one of the multidisciplinary pain clinics which are springing up around the country, they should be able to assess her and offer help.
CRPS is very difficult to manage. The main aims are to relieve pain and increase movement and use of the limb. A variety of treatments are used including:
Drugs: Often the aim is to get a person off powerful analgesics and onto something more simple and effective. Standard painkillers may have no effect in CRPS. Other drugs which are used in addition to painkillers are antidepressant drugs, anticonvulsant drugs, and anaesthetic-type drugs.
Interventional techniques: from surgery to nerve blocks to transcutaneous electrical nerve stimulation.
Psychological approaches: there are different types of programmes, but most use group cognitive behavioural therapy to change patients' attitudes, beliefs, and behaviour in relation to their pain. Controlled studies show that both inpatient and outpatient programmes are effective in improving the pain, with slightly more pronounced gains after the inpatient treatment. The programme usually includes progressive muscular relaxation therapy, goal setting and pacing, group cognitive therapy, education about physiology and pharmacology of pain, and progressive supervised physiotherapy exercises.
Physiotherapy and occupational therapy are helpful in increasing mobility in the limb (early mobilization of any injured limb will help to prevent CRPS in the first place).
Antidepressants can help in two ways
Antidepressants can help pain in various ways. Pain is aggravated by internal factors such as mood or concurrent illness. In your wife's case, her failure to feel better after surgery may be part of the complex causes of pain. In chronic pain it's sometimes very hard to disentangle depression from pain. Pain makes depression worse and depression makes pain worse, so antidepressants may help.
However, in any chronic pain condition (including CRPS) where the nerve may be damaged, causing a particular type of pain called neuropathic pain, a type of antidepressant drug called a tricyclic antidepressant can be effective. This group of drugs, which includes amitriptyline and imipramine, work on pain not through their antidepressant action but by interfering directly with signals in the pain nerves. These drugs are used in lower doses for neuropathic pain than for depression. Anti-epilepsy drugs such as gabapentin, also work in neuropathic pain through their action on the nerves.
Surgery for chronic pain is going out of fashion
Long-term measures, such as cutting the nerves thought to carry a particular pain message, are going out of fashion. The reasoning is that the nervous system will 'rewire', the pain will re-emerge, and may well be more difficult to manage than it was in the first place. Better drug control of difficult pains has also reduced the necessity for destructive procedures.
Cheers Tommy
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I have a different cause for my chronic pain but found that tens worked for me - and still does. I couldn't function in any real way for a long time but now work full time plus do loads of vol. work - my pain hasn't gone away - it varies in intensity instead of being constant so I had to find some coping strategies. I get very tired but I now enjoy my life. My story is at www.bada-uk.org / support forum /'but i still enjoy barbecues!'
Hope you find a solution too - I know tens doesn't work for everyone!
PippinThis is a reply to this message.
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Tens Machines Great.
My little lady got one off Ebay, with the heat pads as well for £15 inc postage....boxed brand new.
It has considerably helped her with her pain. Muscle and Bone. Brilliant.
You have to keep your eye open though as most of them can be quite expensive.
Lloyd's Pharmacy were purportedly selling them for £15 (not including the heat pads) but you would have to check locally as the one in Aberystwyth didn't have them in stock.This is a reply to this message.
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Basically if you don't know what they do. They consist of various size pads that you place next to your skin....they vibrate in various fashions...not extremely vibrate, but gently....causing better blood flow + a sort of massage effect. They have six different settings plus intensity.
Thats it. Simple.This is a reply to this message.
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Lloyds had them here too - one friend I know got them and the pads were useless - she might have just been unlucky though - I paid a lot for my Boots one but it is reliable and I can vary the 'pulse's' a lot which helps as I get used to it too much if I use it for long periods.
PippinThis is a reply to this message.
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Glad it works for you Pippin. I never did get to see the Lloyds Chemist one, perhaps they really are rubbish??
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I have this. My situation is complex not to mention depressing and I won't go into it but there are a few things that you might want to try.
I haven't read the thread so apologies if I am repeating what others have said.
What stage is your condition at? There are medications known to help. These are amitripiline (anti depressant) and gabapentin (I cannot take either unfortunately due to other health conditions).
One thing that I found to be beneficial is autongenic training. Google it. It helps with the fear that develops regarding using the limb.
There are some messageboards for it too, so google for those.
Becca.
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TENs machines are very good. I used them before developing other problems that mean I can't anymore but found them great when I could use them.
Waits for countdown to finish to posting
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With TENS machines, it's important to try different settings. There are two different types of pulse settings on them, and they work differently.
One works like rubbing. It overwhelms the local nerves with low-level signals so that they don't send the main pain signal clearly.
The other works by a sharp (but small) pain triggering release of endorphins in the brain to kill the pain.
One type of pulse may work better for you than the other.This is a reply to this message.
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Thanks NS. I have used both settings in the past and found them beneficial. However, I've been advised not to use one by my specialist because of the effects on the autonomic system (and mine doesn't function correctly) which is why I am no longer allowed to use it.
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hi , i am also suffering with crps and i have found that a really hot bath helps alittle.
i have been do some research on the internet and have found that in america they have done some research and found that a hyperbaric chamber therpy works for crps in most case can cure you need to get a referal from your gp to a dr bonington in manchester infirmary and he then decides if you can have the treatment that is what i am in the process of doing as i am sick of being in pain sick of all the drugs and not being able to do things with my little girl i am 34 and have just ordered my wheel chair i have been awarded full mobility.
you also want to try the saunas but you would have to go 3-4 times aweek that helped me alittle.
are you on any medication????This is a reply to this message.
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HI Kath,
I thought I'd just mention that this thread was made in 2007 (just in case you thought it was current!).
That done. Hello and welcome to Ouch! There are several crpsers lurking around here!
My physio had me doing both hot and cold therapy to try and normalise my hand. She was very good (can't see her anymore because I didn't prgress enough for the nhs to continue seeing me!).
Hope the treatment helps you. Out of interest who told you hyperbaric chamber was a cure? I've not heard of a cure for crps and would be interested in hearing more about this.
Becca
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