rsd, reflex sympathetic dystrophy

[tbeswick2535]

i currently have patient with rsd demonstrating an atypical painfull dystonia displaying as rapid alternating hip and knee flexion /extension. vasomotor instability is present with hyperasthesia.initial thoughts were to treat as for ankle foot clonus with bobaths inhibitory techniques via hallux extension only slight reduction in range of oscillations resulted. pain is extreme, worsens in any attempted weight bearing and sleep patterns grossly disturbed. foot is plantar flexed but triceps surae are not spasmed or shortened passive dorsiflexion of 20 deg is available.my aim is to encourage desensitization of the lower limb via patient self massage and gradual resumption of voluntary controlled motion in deep water hydrotherapy pool 31-32degC. similar case is'' jessica,child in a million" at greater ormond hosp. any other treatment options ideas appreciated

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[Danush]

I had such "ankle case" like this about 15 years ago.
The only real thing that helped him dramaticaly is sympathectomy.
in 2 days after the operation he could step on the affected foot after almost a year of nwb.
the swelling and the sick red color disapeared.
In rsd our "logical" treatment dosn't work. frustrating .....

Dan
P.t.