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Spiegel AM, National Hyperbaric Oxygen Therapy, Palm Harbor, Florida


INTRODUCTION:  Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy) is a debilitating neurological disorder usually precipitated by a trauma to a limb.  The clinical manifestations include swelling of an extremity, severe hyperalgesic pain, changes in skin temperature and color, and weakness.  Frequently it is associated with trophic changes exemplified by loss of hair, and abnormal nail growth.  This study examines the ability of Hyperbaric Oxygen Therapy to reduce the symptoms commonly seen with this disorder in five consecutive patients. 


MATERIALS AND METHODS:  Five consecutive patients (1 male, 4 female) ages 24 to 62 with signs and symptoms of Complex Regional Pain Syndrome confirmed by an independent pain management specialist, and with disability present for 2 to 14 years despite aggressive medical management with stellate ganglion blocks, spinal stimulators, narcotic analgesics were referred for HBO2 treatment.  Each patient received between 20 to 30 treatments at 2.4 ATA for 90 minutes. 


RESULTS:  All five patients had resolution of the hyperalgesic pain and swelling with return of normal limb sensation, temperature, color, strength and function.  Two of the five have returned to gainful employment.   


CONCLUSIONS:  Hyperbaric Oxygen Therapy reverses the reflex vasomotor disturbances thereby reducing swelling and enhancing oxygen perfusion of the effected tissues in patients with complex regional pain syndrome. HBO2 should be considered as a treatment option in patients with this disorder.



RSD Letter from a Parent

Dear A.,

We were quite impressed with the results.  Not total remission, but clearly enabling a semblance of life.

We discovered the treatment through research on the web, not through a doctor.  We asked our surgeon, Dr. O. about it, but he had no familiarity and suggested we discuss it with our pain doctor. Dr. N. had no experience either, but agreed to write a script and give it a try.  I think all doctors involved have been amazed with the results.

I believe the story goes that an RSD victim went diving, and developed the bends.  As a result of the treatment for the bends, the patient’s RSD resolved.  From there, we had heard of about 30 cases where the Hyperbaric Therapy had helped.  There was a nurse, very active on the web, who suffered from "severe RSD" that ultimately convinced us to pursue the treatment.


The treatment involves 2 sessions a day, 5 days a week, for about 2 to 3 weeks.   We did two weeks and then came back for the third. During the treatment, the patient will actually feel a little worse for the first 5 - 8 treatments.  I'm not sure why.  However, they will stabilize, with no improvement for the next 8 treatments.  Virtually everyone we've talked to, who tried the therapy, saw no improvement whatsoever for 15 sessions (week and a half).  This can be disappointing as you expect to feel something.  Between session 15 and 16, while we were in the pool, my son indicated that he actually felt "something" but thought it might just be a good day.  By the end of that week, he said he felt 50% better and by the end of the weekend, if my memory serves me right, he felt 75% better.  We had obligations and could not continue for the 3rd week at that time.  He returned for one more week about a month later. He underwent the HBOT within a few weeks of surgery, so it's hard to clearly attribute pain resolution to either the therapy or the surgery.  However, the symptoms of the RSD really showed up quickly after surgery.  While he does still suffer from some issues, and will probably never be 100%, he has reached a point where he can go on with college.  He starts next week.

I'm attaching literature from the facility in Columbia. They were great to work with. There is also a physician associated with the facility who would write a script, if appropriate (not done in our case as our pain management doctor was happy to give it a try).


Mr. P.


(This patient had been diagnosed with RSD and sought hyperbaric oxygen therapy within 3 months of onset of symptoms. The patient requested names not be used.)


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