Disease States
|
|
Alabama Hyperbaric Oxygen Therapy for CRPS / RSD
Complex Regional Pain Syndrome (CRPS) also known as Reflex Sympathetic Dystrophy (RSD), is a chronic neurological syndrome characterized by:
- Severe burning pain
- Dramatic changes in skin color and temperature
- Excessive sweating
- Tissue swelling
- Extreme sensitivity to touch
CRPS is best described in terms of an injury to a nerve or soft tissue, such as a broken bone, that does not follow the normal healing path. The key symptom is continuous, intense pain out of proportion to the severity of the injury, and tends to become worse rather than better over time. The sympathetic nervous system seems to assume an abnormal function after an injury in that it seems to sustain the pain.
Treatment is aimed at relieving the painful symptoms. Physicians prescribe analgesics, antidepressants, corticosteroids, and opioids. Prognosis varies from person to person. Spontaneous remission has occurred, but others suffer unremitting pain despite treatment.
The results of a double-blind, randomized, placebo-controlled study published in The Journal of International Medical Research in 2004 offers hope to CRPS patients. Of the 71 patients, 37 were in the HBOT (hyperbaric oxygen therapy) group, and 34 to the control (normal air) group. Both groups received 15 HBOT treatments at 2.5 ATA, 5 days per week, one session per day. Pain, edema and range of motion (ROM) were evaluated before treatment, after the 15th treatment, and on day 45. Results: The HBOT group had a significant decrease in pain and edema, and a significant increase in their ROM.
In 1999 a study at the Department of Anesthesiology, State University of New York Health Science Center , reported substantially higher transcutaneous oxygen (tcPO2) level in the HBOT group after sympathectomy compared to the control group, which received isotonic sodium chloride injection. The implication is that sympathetic nerve block of the extremities markedly enhances tissue oxygen delivery during HBOT.
A case report in The Undersea Hyperbaric Med. 1995 performed at The University of Baltimore Medical Center of a 44 year old woman with CRPS reported that the entire foot and ankle were tender, cool to the touch, and range of motion was severely reduced. Physical examination revealed a mottled and cyanotic foot and ankle. HBOT was prescribed, and the patient was asked to keep a log of symptom relief.
Fifteen minutes into the first HBOT she reported relief of pain in the foot, and that is was less cyanotic and warmer to the touch. The foot stayed warm and pink for 8 hours after treatment and pain free for 18 hours. Subsequent HBOT given the following week provided the patient up to 30 hours of relief.
Hyperbaric Center of Alabama provides CRPS and RDS treatment options using hyperbaric oxygen chambers. We serve patients from Alabama, Mississippi, West Georgia and Northwest Florida in our clinic in Birmingham.