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The New Battle Against Complex Regional Pain Syndrome Part 1

  December 02, 2018




By Alexander Germanis

There’s an old saying: “Cut off the head to cure the headache.” In other words, sometimes the method employed to solve a problem is far worse than the problem itself.

One would think in medicine there would definitely be more logical methods applied than simply permanently removing whatever ails you, regardless of the long-term consequences.

Dr. Ramsin Benyamin, Founder and Director of Millennium Pain Center in Bloomington, admits that is, unfortunately, not the case. Medical science has a long history of doing just that: figuratively cutting off the head.

For Complex Regional Pain Syndrome (CRPS) —for a long time known as Reflex Sympathetic Dystrophy — the earlier methods of combating it will soon be seen as medieval in comparison to what can be done now.

Perhaps “Civil War-ish” would be a more appropriate term when looking at earlier treatment methods, as the time of the Civil War is how far back our understanding of CRPS stretches. “It’s an extremely painful condition that affects your extremities, whether it’s your hands or feet,” says Dr. Benyamin. “This is as a result of a minor trauma.”

The trauma can be so minor, explains the doctor, that the pain of CRPS seems downright illogical considering what spurred it. “Say you bump your hand against the door and all of a sudden you develop extreme pain in your hand disproportionate to the initial injury or trauma. The pain can be so bad, in the old days some people would amputate the extremity because of it.”

When the pain occurs as a result of such a minor trauma or accident, the resultant condition is know as CRPS Type 1. In other words, this is when there is no clear cause.

“Sometimes, the pain happens as a result of a nerve injury following a trauma, an accident, or surgery,” explains the doctor. “A clear nerve injury will trigger what is known as CRPS Type 2. This is what, in the old days, was known as causalgia.”

Unlike antiquated methods to treat CRPS, says Dr. Benyamin, “The main goals of modern treatments are to reduce the pain and restore function to the extremity, because that limb, whether upper or lower, sometimes becomes dysfunctional as a result of the pain.”
“How has this been achieved in the past?” queries the doctor. “Through a combination of physical therapy specific to this condition and sympathetic nerve blocks.”

In the case of mild bouts of CRPS, these methods have managed to resolve the problem. However, when the sympathetic nerve blocks cease to be of any help, another method was once employed.

“Traditionally, we have used spinal cord stimulation systems,” the doctor begins. “The most traditional spinal cord stimulation system is what is known as dorsal column stimulation. This is similar to when women are in labor and we infuse medication through an epidural catheter to numb up their nerves so they won’t have pain.”

“But here, a wire goes behind the spinal cord in the epidural space,” he continues. “The wire connects to a power source and patients have a remote control that can turn this on and off on demand to get pain relief.”

The first commercial spinal cord stimulator was built way back in 1968, with Dr. Benyamin performing his first spinal cord stimulator procedure in 1996.

While this was certainly a step in the right direction when it came to fighting CRPS, it was not the end of the road. Dr. Benyamin is happy to say more progress is being made toward improved relief.

He counsels that if you’re feeling pain, don’t just accept the older methods because there are newer, better options out there. After all, when it comes to fighting pain, it’s important not to lose your head.

To learn more about CRPS and the latest method to combat it, read “The New Battle Against Complex Regional Pain Syndrome, Part 2” in next month’s issue of Healthy Cells.

For more information on any type of pain, you may contact Millennium Pain Center at 309-662-4321 or www.millenniumpaincenter.com. Their new office is located at 2406 E. Empire in Bloomington. The practice provides the most advanced and comprehensive pain management for a wide variety of conditions. Drs. Benyamin and Vallejo have been selected among 70 of the Best Pain Physicians in America.
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December 02, 2018

 

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