Irreversible damage can be prevented, according to Dr. Howard Intrater, director of the pain clinic at the Health Sciences Centre in Winnipeg. The sympathetic nerves need to be blocked from sending pain signals.a The Winnipeg newspaper reports that “treatments range from electrical stimulation to beta blockers, epidural stimulators (where an electrode is implanted in the spinal cord to stimulate the affected area) to blocking the sympathetic nerves with injections.” Physiotherapy is used along with acupuncture to decrease pain and improve mobility. The British Medical Journal says that “effective treatment includes some combination of electrical nerve stimulation, chemical blocking of sympathetic nerves, psychological therapy, and intense physical therapy.”

Some Relief at Last!

Eventually, as a last resort, I was sent to a pain clinic for treatment. There I met Dr. Mathew Lefkowitz, a pain-management specialist and anesthesiologist who practices in New York, in Brooklyn Heights. He was very compassionate and understanding. The pain clinic became a refuge for me, especially as I began to understand my disease and the treatment.

Dr. Lefkowitz started with a pain-numbing treatment—regular injections into a nerve in my neck, which would temporarily block the nerve messages causing the pain. As he explained it, the pain is triggered by the sympathetic nervous system. This is the brain’s normal protective reaction to injury or surgery. The theory is that this system is supposed to act like a gate. The nerve sensations go through only while the wound is healing. At a certain point, when the brain sends no more nerve impulses, the gate closes and the pain disappears. In RSD, the gate does not close. The sympathetic nervous system never calms down. It continues to act as if there were still an injury at the site. The doctor told me to come to the clinic immediately any time the pain intensified. Thus, I have been on a regular routine of pain-blocking injections for quite a while.

The injections helped me to tolerate physical therapy, which gives a range of motion to the affected limb and is very helpful for this condition. As time went by, I began to do simple tasks, using both arms and hands. It was a positive beginning.

A Doctor’s Viewpoint

Awake! interviewed Dr. Lefkowitz for his description of the treatment. He explained: “We handle all kinds of pain, not just RSD. The most common pain ailment is lower-back pain, which often leads to very painful sciatica. While pain is obviously physiological in origin, there are often psychological influences as well.”

Awake!: Can RSD attack all ages and both genders indiscriminately?

Dr. Lefkowitz: Yes, there is no partiality with this disease. However, we cannot foretell who is more likely to be affected. What I do know is that women usually tolerate pain better than men do. They seem to have a higher pain threshold.

Awake!: What treatments do you recommend for pain?

Dr. Lefkowitz: There are various methods we can use, depending on the source and the intensity of the pain. After all, pain means suffering, and we need to alleviate that suffering. In some cases we use nonsteroid pills, such as aspirin, and their variants. In other cases, such as Karen’s, we use a regional nerve-blocking drug. In extreme cases we might use an opiate. The drawback there is that we have to watch out for possible addiction.

Awake!: Is it inevitable that RSD should pass through all the stages of development?

Dr. Lefkowitz: No, it is not. If we can catch the disease at an early stage, we can abort the process. Take Karen, for example. She is in an intermediate stage, and she may not necessarily go into the final stage of limb atrophy.

Awake!: What do you suggest to help a patient cope with the situation?

Dr. Lefkowitz: Precisely what Karen has done. She has tackled her pain at a psychological level by distracting her mind with pleasant thoughts and images. She is also using physical therapy. And I believe that her faith has been a big help. It has helped her to focus on the situation in a positive manner. Yes, I cannot emphasize faith too much.

Awake!: Thank you very much for your time and patience.