Knee Problems archives

frozen knee joint/rsd

Posted by mark olesen on October 22, 1998 at 20:34:01:

Hello Dr.Stoll,
My friend broke her left patella June 3. Evidently the cast and or brace were left on too long with a resulting frozen joint. DR. appointments were over a month apart and she experienced a lot of swelling, discoloration, temperature differential and pain in the meantime. They did not let her out of the brace until late August! At that time she began P.T. but the joint would never go beyond 35 degrees, and the pain and swelling rapidly worsened.
It was not until Oct.6th that she was diagnosed with RSD by the attending orthopedic dr. She was referred to a dr.who insists the only cure for RSD is six or more spinal blocks, and she would still have frozen knee joint. She is certain there is a better way. We would greatly appreciate your help and suggestions. Thankyou Marko)


Follow Ups:


Re: frozen knee joint/rsd

Posted by Walt Stoll on October 25, 1998 at 10:42:46:

In Reply to: frozen knee joint/rsd posted by mark olesen on October 22, 1998 at 20:34:01:

Dear Marko,

What does RSD stand for? I am sure I know it by another name and hesitate to say anything till I know that.

Walt



Follow Ups:


Re: frozen knee joint/rsd

Posted by mark olesen on October 25, 1998 at 23:49:35:

In Reply to: Re: frozen knee joint/rsd posted by Walt Stoll on October 25, 1998 at 10:42:46:

Hello DR.
I am sorry I should have stated that RSD stands for reflex sympathetic dystrophy. The orthopedic surgeon wanted to anesthetize my friend and manually manipulate her frozen knee joint,and put her on a continuous passive motion machine so she can move her knee joint again. However, this was before the RSD diagnosis. We are coming up on five months since the patella was broken. Both specialists state that time is of the essence. The pain specialist insists that the knee manipulation will not help at this point, and that the drastic spinal blocks are required to break the pain cycle. She is terrified of this procedure, and not even convinced of the RSD diagnosis. No testing was done! Please help us..... SOS...... Thankyou Mark Olesen))))




Follow Ups:


Re: frozen knee joint/rsd

Posted by David Ferguson, D.C. on October 26, 1998 at 08:34:44:

In Reply to: Re: frozen knee joint/rsd posted by mark olesen on October 25, 1998 at 23:49:35:

I don't know for sure if chiropractic could be of help here with spinal adjustments but it seems to be logical in theory. Since your looking for any options I thought I'd throw that in there.

Dave

Spinal Component Identified In RSD

OBJECTIVE: To determine whether the mechanisms of reflex sympathetic dystrophy, a
neuropathic pain syndrome characterized by skin blood flow abnormalities associated with
sympathetic vasoconstrictor and antidromic vasodilator mechanisms, are solely of peripheral origin
or have an additional spinal component and act exclusively through neural or also involve humoral
pathways.

PATIENTS: The 54 patients with unilateral reflex sympathetic dystrophy were divided into the
following three stages according to their perception of skin temperature in the clinically affected
hand: stage I, stationary warmth sensation; stage II, intermittent warmth and cold sensation; and
stage III, stationary cold sensation.

METHODS: Investigation of basal skin blood flow and vasoconstrictive response to dependency
of skin microvessels in the clinically unaffected hand and the clinically affected hand of patients with
reflex sympathetic dystrophy and the left hand of 16 control subjects. Microcirculation was
investigated at the predominantly neurally controlled thermoregulatory level (Doppler laser
flowmetry) and at the predominantly humorally controlled nutritive level (capillary microscopy).

RESULTS: In the clinically unaffected hand, at the thermoregulatory level of the microcirculation:
(1) basal skin blood flow was increased at stage I compared with the control subjects, whereas no
differences could be observed at this stage compared with the clinically affected hand; (2) the
vasoconstrictive response to dependency (defined as skin blood flow at heart level divided by skin
blood flow in the dependent position) was attenuated at stage I compared with the control subjects,
whereas no differences could be observed at this stage compared with the clinically affected hand;
and (3) basal skin blood flow and the vasoconstrictive response to dependency did not differ from
the control subjects at stages II and III. In the clinically unaffected hand, at the nutritive level, no
differences could be observed at any stage of the syndrome compared with the control subjects.

CONCLUSIONS: This study indicates that there is a spinal component to microcirculatory
abnormalities at stage I of the reflex sympathetic dystrophy syndrome that most likely acts through
neural (antidromic vasodilator) mechanisms and that may be initiated by traumatic excitation of a
peripheral nerve on the clinically affected side.

Kurvers HA, Jacobs MJ, Beuk RJ, van den Wildenberg FA, Kitslaar PJ, Slaaf DW, Reneman RS. The spinal component to skin blood flow
abnormalities in reflex sympathetic dystrophy. Arch Neurol 53 (1): 58-65 (Jan 1996)



Re: frozen knee joint/rsd

Posted by Walt Stoll on October 26, 1998 at 09:40:57:

In Reply to: Re: frozen knee joint/rsd posted by mark olesen on October 25, 1998 at 23:49:35:

Dear Mark,

This is a very serious diagnosis and it is mainly made by the history AND the x-ray appearance.

Time IS of the essence. If I had this, I would go ahead with the manipulation under anesthesia and seriously consider the spinal blocks so long as they would be temporary.

I would also go with the Chiropractic manipulation at the same time since ANY motion will help and, as Doc Dave said "It couldn't hurt."

This is one of those things that conventional medicine doesn't have a reliable solution for but is still the best thing we know to do.

I would also do all of the things listed in the archives for this bb that have to do with joint repair (skilled relaxation, glucosamine, etc.).

Good luck to your friend. A joint replacement may be in the cards for her in the future.

Walt




I had RSD (now called CRPS) and am now cured

Posted by Sue Breeding on October 26, 1998 at 20:55:40:

In Reply to: frozen knee joint/rsd posted by mark olesen on October 22, 1998 at 20:34:01:

Mark and all,

If you have reached the stage where RSD or CRPS (Complex Regional Pain Syndrome) is diagnosed, you will probably have to go with a pain specialist's spinal treatments. Add a complete change in your diet and skilled relaxation, and you are on your way to a complete cure.

I am 90% cured of CRPS. When I started out, I couldn't even touch the floor with my foot, much less walk.
Now I walk normally, exercise on the bike and treadmill, and am healthier than I've been in my life.

If you want more details or information, please e-mail me.

Sincerely,

Sue Breeding
Houston, Texas


Follow Ups:


Re: I had RSD (now called CRPS) and am now cured

Posted by Walt Stoll on October 27, 1998 at 11:54:33:

In Reply to: I had RSD (now called CRPS) and am now cured posted by Sue Breeding on October 26, 1998 at 20:55:40:

Thanks, Sue!

It is testimonials like this that help more people than anything I can say.

Namaste` Walt




Re: I had RSD (now called CRPS) and am now cured

Posted by Annette Cope on January 07, 1999 at 12:01:52:

In Reply to: I had RSD (now called CRPS) and am now cured posted by Sue Breeding on October 26, 1998 at 20:55:40:

Dear Sue: I was diagnosed with RSD 9 months ago. My RSD not only involves pain in my right arm, but has caused severe heart palpitations (I'm told I have the heart of an athlete), burning on one side of my face, recurring loss of vision in my right eye, lumps in my throat, profuse sweating on one side while freezing on the other side and many other symptoms. My family as well as myself thought that I was crazy. Have been using chiropractic care for treatment. Ready to get on with my life. Any help that you can provide me on how you reclaimed your life from this debilitating disease would be much appreciated. Annette Cope



Return to Dr Stoll Home Page

Post a Message

Main Archives Page

More Knee Problems archives