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ChildMuscleNerve, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5
Experience:  Board Certified Child Neurologist. Training in neuromuscular disorders. Over 12 years experience
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I have been diagnosed with CRPS or RSD for years and am in

Resolved Question:

I have been diagnosed with CRPS or RSD for years and am in much chronic pain in my left thigh from 3 failed hip replacements. I use a cane mostly and am in constant pain.. My doctor wants to send me to a nurologist for some tests. My question is what is the connection ,why a neurologist and what tests would be run. Anything invasive like a spinal tap? or x-rayss (radiation) or anything that's painful? I've had epidurals without success by a pain management doctor...I don't see the connection and would rather not go if it'll just be more painfull tests of even x-rays because of the radiation..which I've had plenty of and what could he do anyway. I mean the question with the utmost respect. Just don't get it? Is it just for a diagnosis?
Submitted: 7 years ago.
Category: Neurology
Expert:  ChildMuscleNerve replied 7 years ago.

CRPS/RSD is a diagnosis made on clinical signs and symptoms. There are no tests to confirm the diagnosis. Your doctor may want to make sure there isn't a problem with the nerves in your thigh from other reasons, like diabetes or problems with your immune system. A neurologist may want to do a nerve conduction study to see how your nerves are working and rule a nerve problem out as the cause. They may want to do imaging studies of your hip, like an MRI to make sure there isn't a nerve trapped somewhere causing the pain that can be relieved surgically. So, it's not a bad idea to be evaluated by a neurologist.

Most patients with CRPS respond very well to intense physical therapy and pain medications to help get the therapy started with minimal discomfort. These medications can include seizure medications, such as gabapentin or an antidepressant, such as nortriptyline. Many neurologists are versed in these chronic pain meds.

In any event, I hope you find relief soon.


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Customer: replied 7 years ago.
Relist: Answer quality.
Expert:  ChildMuscleNerve replied 7 years ago.

I am sorry you are unhappy with the answer I provided. The simple response is yes, the referral would be for a diagnosis and hopefully provide further treatment options. Is there more I can answer for you?

Customer: replied 7 years ago.
Is there any reason for a spinal tap that a friend said he got when he went in ..How then is CRPS confirmed for dissabilty. I'm in alot of pain.
Expert:  ChildMuscleNerve replied 7 years ago.

There should not be any reason for a spinal tip since your pain is localized to your thigh. Neurologists do order them for many reasons, but chronic pain is not usually one. You always have the right to refuse to get one unless they can give you a good reason why you should have it.

CRPS is solely a clinical diagnosis. The typical presentation is chronic pain, usually described as burning in nature, accompanied by changes in skin color, either pale or flushed, and changes in skin temperature, cooler or warmer. The symptoms can fluctuate over the course of the day and are often worsened by trauma. If this does not sound like your symptoms, it would be another good reason to be evaluated by a neurologist. With 3 hip surgeries you can have scar tissue that compresses a nerve and causes significant pain. This would require a different treatment than CRPS.

Usually the folks approving disability just need the diagnosis to come from a neurologist or pain medicine specialist. for them to approve the disability. The specialist than fills out a form describing the limitations the person has.

I hope that answers your question better.