Neuroma and Regional Pain Syndrome - Essay Example

Neuroma and Regional Pain Syndrome Complex Regional Pain Syndrome, CRPS, has been a confusing medical disorder which the medical fraternity has never quite understood in depth. Since its emergence in the 16th century, it has been given different names such as causalgia, shoulder-hand syndrome, and reflex sympathetic dystrophy amongst others. It was not until 1994 that the general term Complex Regional Pain Syndrome was adopted to bring some uniformity to the matter. Neuroma is the primary cause of CRPS. It is a disorganized growth of cells which is usually painful, and emerges at a point of cut, excessive stretch, or injury (Sebastin n.p.). The following research text discusses the relationship between Neuroma and CRPS, the symptoms of the two ailments, and the steps of diagnosing them. A Neuroma occurs mostly after surgeries such as limb amputations and manifests itself as a ball-shaped mass which is painful at the application of even the slightest pressure. At times, the Neuroma affects a larger area around it; the adjacent skin becomes painful, blood circulation is affected, hair growth is affected, and bone density may decrease. This is what is termed as Complex Regional Pain Syndrome. The symptoms may include extreme sensitivity in the affected which are extremely painful. Additionally, some changes occur to the affected skin such as harder texture, more shine, and abnormal sweating patterns. The color may change as well. In the event that a joint is affected, it becomes stiff and affects the muscle coordination thus affected motor abilities (Thordarson 96). Generally, the affected limb is harder to move, and may tremble or jerk on its own from time to time. CRPS affects not only the limb but the whole body. This is particularly so because when say, a limb is affected, thus rendered unable to perform normally, an individual is made weaker. This affects the execution of daily activities or professional roles. Even in its Neuroma stage, a person is still made weaker because the affected parts with swellings cannot withstand pressure or touching, and this may also hinder one’s ability to perform their daily activities. In short, one becomes weaker in general body performance. The process of diagnosing the disease is as complicated as understanding it. This is so because there are multiple causes which may present similar symptoms and for that, critical and very careful examinations are necessary. One of the major methods of diagnosing it is by evaluating the medical history of the affected persons. This may be for instance, evaluating the period since they had a surgery performed, and the pre-existing issues such as pain. History of injuries is also important in diagnosing CRPS (Mense, David &Russell 62). The other method is physical medical examination of the affected person. In these procedures, three issues are usually being addressed; the first is comparing between the affected and unaffected limbs. The second one is determining whether there existed any traces of sensory, motor, or trophic signs which might hint the existence of CRPS. The third issue is usually checking to identify whether any nerve disturbances or injuries exist. Conducting bone scan is another method of diagnosing CRPS. In bone scans, it is possible to identify changes in the bone structure (metabolism) thus rule the presence or absence of the disorder. There are several observations which might indicate the presence of CRPS such as excessive release of calcium into the bloodstream, breaking down of particular cells in the bone, and excessive resorption in the bone. Such tests are important in ruling out similar bone-affecting ailments such as arthritis. Apart from bone scans, X-ray tests may be administered, or Magnetic Resonance Imaging in evaluating the nature of the bone, and whether any irregularities are evident. Testing of the immune system’s response patterns also hints whether any nerves are affected or destroyed, thus show presence of CRPS. Especially with Neuroma, anesthesia is injected into the affected area then slight tapping is done on it. Depending on what the patient feels, it can be told whether their nerves have been affected by prior injuries or surgery. If that is the case, the possibility that they have CRPS is increased, and further tests are administered. Treatment of CRPS and Neuroma is aimed at restoring normal limb function. There are multiple ways through which treatment can be administered but this depends on the cause. In addition, early diagnoses allow for better medical intervention thus improvement. The first treatment offered is physical therapy which seeks to eliminate the swelling of Neuroma and the pain (CRPS). This may include massage, elevation, varying limb exercises, and other restoring activities whose outcome should be reducing, and not escalating the pain (NHS n.p.). The other treatment offered is pharmacologic intervention by use of medication. Depending on the level of pain that one experiences, the drug can be determined. Patients with severe pain are treated with drugs that control opioid release, thus allow for therapy. Other anecdotes are also administered as, and when necessary or applicable. Another pharmacologic intervention is by using regional anesthesia termed as “regional” and which seeks to block some nerves which seem to be affected and are slow in responding. This gives the patient relief from pain and allows the other responding parts to recover fully. The final method of intervention is through surgery. Although termed as an option, it is not the best since it has some complications of its own. It is however opted for in situations such as removal of the swellings caused by Neuroma or relieving pain (CRPS). In the removal of the swelling (stump), surgeons cut into the affected area and remove the abnormal nerve growth. This is chiefly for the neuroma cases. CRPS is usually as a result of neuroma, and surgery can be conducted to correct the problem such as unblocking nerve channels, freeing tight tendons, and replacing normal body structure affected by neuroma or injuries. Concisely, the second type of surgery is meant to curb the spread, recurrence, or resolving CRPS which results from persisting Neuroma (Dellon, Andonian, & Rosson n.p.). Works Cited Brown, Edward, Scuderi, Giles & Clarkee, Henry. “The Painful Total Knee Arthroplasty: Diagnosis and Management.” Healio, 2006. Web. 9 July, 2014. Dellon, Lee, Andonian, Eugenia & Rosson, Gedge. “CRPS of the Upper or Lower Extremety: Surgical Treatment Outcomes.” NCBI, 2009. 4 (1). Web. 9 July, 2014. Mense, Siegfried, David G. Simons, and I J. Russell. Muscle Pain: Understanding Its Nature, Diagnosis, and Treatment. Philadelphia: Lippincott Williams & Wilkins, 2001. Print. NHS. “Complex Regional Pain Syndrome- Treatment.” NHS.uk, 2014. Web. 9 July, 2014. Sebastin, Sandeep. “Complex Regional Pain Syndrome.” NCBI, 2011. 44 (2). Web. 9 July, 2014. Thordarson, David B. Foot and Ankle. Philadelphia: Lippincott Williams & Wilkins, 2004. Print. Read More