Reflex sympathetic dystrophy: early treatment and psychological aspects

We report the results of two prospective studies of early treatment and psychological aspects in a series of 26 patients with sympathetic reflex dystrophy of the hand in which treatment was started within 3 months after diagnosis. Ismelin blocks is an often used therapy in sympathetic reflex dystrophy but a probable better therapy in the first stage of the dystrophy was also investigated. Thirteen patients were treated with Regional Intravenous Ismelin blocks and 13 other patients were treated with a hydroxyl radical scavenger, dimethylsulfoxide (DMSO). After 9 weeks there was a better result in the group treated with DMSO. This report also describes psychological research in a group of 24 dystrophy patients compared with a control group of 42 patients who underwent elective hand-surgery. Women dystrophy patients were more depressed and emotionally unstable. Eighty percent of all dystrophy patients had a recent life-event while only 20% of the control group members reported such an event. These two features seem to be independent. Early diagnosis in combination with early stress management training and a multidisciplinary treatment tends to be a very good solution.