When a client with a diagnosis of RSD/CRPS as a result of some traumatic injury (usually a minor one) comes to my office they need to know what they can do to improve the chances of getting a substantial recovery. I am helping a client now who had a sprained ankle in a restaurant. The severe RSD signs and symptoms did not show up for several months. This makes a diagnosis of RSD harder because usually the pain and symptoms ease up as time goes by. Hopefully the lessons learned from helping other clients will be helpful to maximize your recovery.
1. You must be prepared for the defense that you do not have RSD. The defense will claim that you already had some kind of painful condition before, and that you are in a state of denial about the real reasons for your RSD. This defense may come from a review of your old medical records which for example might include back surgery with lingering complaints of pain as you recovered. This type of pain is a red herring in my opinion. EVEN IF you have lumbar pain, sometimes called sciatica or radiculopathy, it is entirely medically possible for a traumatic event to occur which magnifies or worsens the pre-existing medical condition. An honest defense doctor will have to admit that a person like you,even if you have a “Failed Back Syndrome” or “Transitional Pain” following a lumbar fusion AKA arthrodesis, is also subject to getting RSD after a trauma.
2. The “gold standard” to prove whether you have RSD/CRPS is a diagnostic test called a Triple Phase Bone scan. This is considered the best proof of RSD/CRPS by pain management doctors. This test is done by injecting a special dye into the body. After a couple of hours the person is sent to get an image done of the area believed to have RSD/CRPS. The picture will show a collection of the dye in the affected area, which is attracted to the area by the metabolism of the bones. The test says something like : RSD or Osteomyelitis is causing the uptake. A blood screen is done to rule out Osteomyelitis. So, if your doctor has not sent you to get one of these tests, ask him to do so.
3. There is a great book which you should get. It is called Medifocus Guidebook on Reflex Sympahetic Dystrophy. It is available at Amazon.com and collects all of the latest medical information about RSD/CRPS.
4. Get a digital infrared thermometer. Learn how to use it and document temperature differences between the affected limb and the non affected limb. Temperatures within 2 degrees are not significant. Take photos of the affected limb especially when there are color changes, or changes in your fingernails or hair.
5. Go to a doctor who specializes in Pain Management. Doctors who are not specialists in this disease do not have the special skills, knowledge or training to diagnose the disease or treat it. Believe it or not, but most doctors do not get any special training in Medical School or as a resident on how to diagnose and deal with chronic pain. They do not know that the signs and symptoms of RSD/CRPS come and go, sometimes worse than others, sometimes there and sometimes not there. The constant is the horrible disproportionate pain, not usually caused by a minor trauma.
6. Do not be reluctant to go see a shrink. This terrible condition requires help on all levels, and ultimately it is helpful to have evidence that your mind is not just playing tricks on you. This is called a “somataform” pain disorder, or a factitious disorder. The defense will claim it is “all in your head” without giving you credit for the fact that the pain is real, not just being faked. There are certain diagnostic tests like the MMPI-2 which are standardized. They rule out fakers and malingerers and destroy the defense that it is all in your head.
Finally, get a lawyer who has had experience with RSD cases. The last one I tried resulted in a Verdict of $1,320,000. My client was thrilled and thanked me for giving him his life back. Other lawyers had recommended that he take $200,000 and run!