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Related Experiment Videos

Reflex sympathetic imbalance. Response to epidural blockade.

A L Ladd1, K E DeHaven, J Thanik

  • 1Department of Orthopaedic Surgery, University of Rochester Medical Center, New York.

The American Journal of Sports Medicine
|September 1, 1989
PubMed
Summary

Epidural sympathetic blockade offers relief for reflex sympathetic dystrophy, but recurrence is common. Long-term management requires ongoing therapy and prevention of triggers for successful rehabilitation.

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Area of Science:

  • Pain Management
  • Neurology
  • Rehabilitation Medicine

Background:

  • Reflex sympathetic dystrophy (RSD), now known as complex regional pain syndrome (CRPS), is a debilitating condition characterized by severe pain and disability.
  • Epidural sympathetic blockade is a treatment option for managing RSD, particularly in cases of sympathetic imbalance.

Purpose of the Study:

  • To evaluate the effectiveness of epidural sympathetic blockade in treating reflex sympathetic imbalance, an incomplete form of RSD.
  • To assess the long-term outcomes and management strategies for patients with RSD.

Main Methods:

  • Eleven patients with reflex sympathetic imbalance affecting the knee or ankle were treated with epidural sympathetic blockade.
  • Follow-up included clinical assessment, monitoring for relapse, and evaluation of adjunctive therapies.

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Main Results:

  • Initial blockade provided a favorable response in all but one patient.
  • Seven patients required repeat blockade due to clinical relapse.
  • Recovery was prolonged, necessitating adjunctive therapies like physical therapy and TENS (transcutaneous electrical nerve stimulation).

Conclusions:

  • Epidural sympathetic blockade can be effective for reflex sympathetic imbalance, but relapses are common.
  • Successful rehabilitation requires prolonged treatment, including adjunctive therapies and proactive management of recurrence triggers.
  • Early diagnosis and intervention are crucial for better patient outcomes.