Experiencing physical pain is never a fun or welcome experience, but the pain associated with chronic pain conditions like RSD can be life-altering. It can also feel impossible to describe to someone who doesn’t spend every day of their life in agony that has no apparent cause, making you feel crazy. And when that crazed feeling begins, it can increase stress levels, further exacerbating the pain you’re experiencing. It can feel like a vicious cycle with no end, but there is an effective RSD flare-up treatment available that can help you feel like yourself again—ketamine.
What is RSD?
Reflex sympathetic dystrophy (RSD) is an older term used to describe one form of complex regional pain syndrome (CRPS). This chronic neuro-inflammatory disorder—sometimes called Type I CRPS—is characterized by severe burning pain, usually in one of the extremities.
Type I CRPS is triggered by an illness or tissue injury with no underlying nerve damage. RSD is also unique in how it affects the muscles, bones, skin, blood vessels, and nerves simultaneously. Type II CRPS, on the other hand, is triggered by a previous high-velocity trauma, such as a gunshot wound, that causes clear nerve injury.
What Are Symptoms of RSD/CRPS?
The most obvious symptom of CRPS is the long-standing, intense, out-of-proportion pain in relation to any injury that may (or may not) have occurred. Another key factor in diagnosing RSD is that the pain worsens over time rather than improving. Other common symptoms of CRPS include:
- Deep, aching cold and/or burning pain
- Increased skin sensitivity to touch
- Abnormal hair/nail growth patterns
- Inconsistency in skin temperature (one extremity is warmer/cooler than the other side)
- Abnormal skin color changes (often blotchy, pale, red, or purple)
- Swelling and/or stiffness in the affected area
- Abnormal skin texture (thin and shiny; could be excessive sweating)
- Motor disability in the affected limb
- Muscle spasms, weakness, tremors, or loss (atrophy)
- Depression, anxiety, stress, of fatigue from extreme physical pain
Two other prevalent and important-to-note symptoms of RSD are:
- Moderate-to-severe pain associated with allodynia, a heightened pain in response to something that shouldn’t be painful (like clothing or water touching your skin), and
- Continued pain associated with hyperalgesia, or excessive sensitivity to painful stimulation.
According to the National Institute of Neurological Disorders and Stroke, CRPS is most common in women. Although it can occur in anyone at any age, most cases peak around age 40.
How Long Do RSD/CRPS Flare-Ups Last?
An RSD flare-up is something many people will experience after they develop CRPS Type I. Flare-ups are characterized by acute, intense worsening of symptoms—particularly increased pain. People with CRPS flare-ups might experience this spike in symptom intensity for just a few hours or up to weeks and months in extreme cases. Most flare-ups, however, won’t last longer than a few days.
Flare-ups can be caused by many different triggers, including the following:
- Other chronic illnesses
- Weather changes (temperature, barometric pressure, etc.)
- Extreme emotions
- Physical overexertion
- Sitting in the same position for too long
- Dietary changes
- Medication changes
It’s a good idea to keep a symptom journal where you note the lifestyle factors or health changes that may be causing your symptoms to worsen and share this information with your doctor when seeking treatment.
CRPS Alternative Treatments
If not treated effectively, residual pain from a flare-up can last for weeks after the event, and to date, no one has treated CRPS with as much success as doctors administering therapeutic IV ketamine to their chronic pain patients. There are, however, many methods people with pain syndromes like RSD use to manage symptoms associated with flare-ups. Still, while there are plenty of great options for minimizing pain, ketamine is the most effective drug for treating the root cause of RSD-related pain.
Home remedies are a great way to manage pain levels during a flare-up or between doctor visits but should not be substituted for medical care from a board-certified physician:
- Relaxation techniques like diaphragmatic breathing, meditation, massage, and Epsom salt baths
- Daily exercise (as tolerated), including stretching, walking, swimming, biking, and yoga
- Eating an anti-inflammatory diet of leafy greens, berries, nuts, and fatty fish
- Heat therapy, such as heated blankets or the use of an infrared sauna
Oral medications can be used to treat symptoms of CRPS Type I—or RSD—but they can come with serious side effects, particularly opioid medications, which have an extremely high potential for abuse without offering meaningful pain relief for patients. For people with CRPS, opioid medications should be considered a non-option. Side effects for common medications prescribed include:
- Anticonvulsants: drowsiness, dizziness, and headaches
- Tricyclic antidepressants: nausea, vomiting, and drowsiness
- Corticosteroids: headaches, dizziness, and insomnia
- Bisphosphonates: acid reflux, indigestion, and constipation
- NSAIDs: nausea, dizziness, and headaches
Some doctors will prescribe opioid medications for CRPS, but it’s important to know how dangerous these drugs can be—especially for those with chronic pain syndromes.
Therapies & Procedures
The therapies and procedures available to treat pain caused by complex regional pain syndromes, like RSD, are high in number and wide in scope. Still, one of the most effective, long-term treatments recommended by the Reflex Sympathetic Dystrophy Syndrome Association is IV ketamine therapy administered in a safe, relaxing environment.
Additional therapeutic methods include:
- Acupuncture to stimulate blood flow, reduce inflammation, and stimulate nerve regeneration
- Physical therapy to improve circulation and strength of the affected limb
- Spinal cord stimulation, which uses electrodes to block pain signals in the spinal cord before they can reach the brain
- Psychotherapy to address the mental/emotional challenges of the condition
While these are great options to bolster your primary treatment efforts and provide short-term pain relief between doctor visits, these methods will not provide patients with long-term pain relief and symptom management.
What is the Best Treatment for RSD?
To find true relief from an RSD flare-up, it’s important to understand the cause of the increased pain—a neurotransmitter called NMDA. This brain chemical causes the constant, intense pain patients feel during a flare-up, so treatment should be focused on stopping NMDA activity within the brain. The best way to halt this activity is with an NMDA antagonist medication like ketamine.
Clinical studies have shown that high-dose ketamine infusion therapy is a safe and effective treatment that allows sufferers to find relief by resetting their central nervous system’s sensitization to pain signals from the brain. The ketamine treatment protocol for RSD patients involves six-hour high-dose infusion appointments where the patient will receive four hours of active infusion time before having two hours of recovery time before they’re released to go home.
Ketamine treatment for RSD usually begins with an infusion of 1mg/kg/hr, but your doctor may adjust the dose as needed. The initial series of infusions will require five infusions every day or every other day, followed by a maintenance infusion every six to eight weeks as needed. Most patients begin to experience relief within hours of their first appointment and experience significant continued relief throughout the course of their treatment.
Get Lasting Pain Relief from RSD—Mindscape Ketamine & Infusion Therapy
If you’re suffering from persistent RSD flare-ups that affect your day-to-day functioning, it’s important to talk to a doctor about your treatment options. And although managing your symptoms at home can help marginally relieve the pain, RSD flare-up treatment often requires medical intervention—such as IV ketamine—to experience true long-term relief.