Complex Regional Pain Syndrome Type 1 & 2(Reflex Sympathetic Dystrophy) Cause of Facial Pain

Another poster (thanks @Meldaver) brought up the possibilty of RSD. Reflex Sympathetic Dystrophy is now classified as Complex Regional Pain Syndrome Type 1 or Complex Regional Pain Syndrome Type 2. It is a very plausible explanation for the facial pain many of our members experience and frankly a whole lot better that ATN which doesn’t answer anything most of the time.

Type 1 complex regional pain syndrome (CRPS 1) is a clinical syndrome of variable course and unknown cause characterized by pain, swelling, and vasomotor dysfunction of an extremity. This condition is often the result of trauma or surgery. Limb immobility may lead to CRPS 1; in a hemiplegic upper limb after stroke, the syndrome is often termed shoulder-hand syndrome. CRPS 1 may also develop in the absence of an identifiable precipitating event.
Current taxonomy categorizes CRPS 1 as occurring in the absence of definable nerve injury.

Type 2 CRPS, causalgia, develops after nerve injury; the term causalgia was coined by Mitchell in 1864 and derives from the Greek for burning pain. In patients with either type 1 or type 2 CRPS, sympathetic mediation of the pain (ie, improvement with sympathetic blockade) may or may not be evident. Tooth extractions, cervicogenic issues, trauma etc are all possible explanations.

There is an excellent article in medscape. Generally the BEST specialist to deal with this issue is a Rheumatologist. The worst (IMHO) is a surgeon if for no other reason surgery or too much surgery (especially dental) is the cause. More surgery only makes it worse. Chiropractic, Physical therapy, osteopathy, Occupational Therapy, and in extreme cases Pain management Multi-disciplinary practices are great allied proffesions.

Treatment of this condition as it becomes better known and understood is gaining a lot of traction and success. Its taken a long time for some (there needs to be more) surgeons to understand they are part of the problem as opposed to part of the solution.

MVD without clear evidence of compression is nearly a thing of the past. Better Data on outcomes is making it less frequent even with evidence of compression. The fact is there is nerve compression throughout your body for a number of reasons (including obesity, musculature, generalized inflammation etc) without similar results.

Thank You-that was one thing the neurologist thought about for a few seconds and disregarded.Maybe he will have changed his mind on my return appointment

What concerns me with this possible diagnosis is it’s ability to spread through out the body

@coreysarah Not really thats why its called regional. But in any event what you name it doesn’t matter near as much as how you treat it.

Absolutely agree on the treatment statement just scares me none the less. I’ve tried two stellate blocks but they haven’t helped

We are only scared of what we don’t know. The trouble is with these condtions thats often a lot. Hang in there