Case: Reflex Sympathetic Dystrophy

[Guest guest]

Recently I began treating a 50 yo male diagnosed with RSD.

The patient was injured when a 1600lb concrete block struck

the 5th right metatarsal 3 years ago. For the first year

or so he experienced a great deal of pain that referred from

the little toe to the heel. After a year of constant pain

and edema he received a nerve block and the pain subsided

only to be replced by hypoesthesia all along the UB channel

of the right foot. When he came to see me 3 weeks ago the man

presented as extremely heavy,profuse odorous perspiration,

no thirst, strong appetite, difficulty walking as he favors

the right leg and is frequently depressed about his health.

Tongue: Large reddish/purple body with a greasy white tongue

coat. Pulse: Slippery and softer/slippery on the left side.

 

The patient often has difficulty sleeping or resting for that

matter as his right leg will twitch uncontrollably when he

tries to rest. In fact he feels best when he is on the move,

but begins to experience severe causalgia of the heel and

between the 4th and 5th metatarsals if he works too hard.

He is employed as an instrustor at a maritime academy and

will often operat heavy machinery.

 

When I examined the lower limbs I found the right limb to

at least 3 cm greater in circumfrence than the left with

pitting around the right ankle. Also the medial aspect of

the lower limb (SP channel from Sp8 to SP6) there was a red

pinpoint rash on the skin; the rest of the limb especially

the ankle appeared almost transluscent with purplish blue

nevi

on the dorsum (between St42 & GB41). The patient did not

feel any pain on palpation.

Initial diagnosis: Channel Obstruction due to Damp/Heat

with Blood Stasis; Vacuity of Spleen with retention of

Dampness and Depression of Liver Qi.

 

I primarily treated with acupuncture and have had some

success ( decreased edema 30-40%, less or no causalgia

for 3-4 days at a time). For one week I prescribed Yu Nan

Bai Yao to Harmonize Blood. This week we will begin with

a variation of Si Mao San.

 

Please provide your insights, comments and suggestions.

 

Regards

 

Aris Skaliotis