To determine whether the mechanisms of reflex sympathetic dystrophy, a neuropathic pain syndrome characterized by skin blood flow abnormalities associated with sympathetic vasoconstrictor and antidromic vasodilator mechanisms, are solely of peripheral origin or have an additional spinal component and act exclusively through neural or also involve humoral pathways. Investigation of basal skin blood flow and vasoconstrictive response to dependency of skin microvessels in the clinically unaffected hand and the clinically affected hand of patients with reflex sympathetic dystrophy and the left hand of 16 control subjects. In the clinically unaffected hand, at the nutritive level, no differences could be observed at any stage of the syndrome compared with the control subjects. The spinal component to skin blood flow abnormalities in reflex sympathetic dystrophy. Dear Mark, This is a very serious diagnosis and it is mainly made by the history AND the x-ray appearance.
Time IS of the essence.
If I had this, I would go ahead with the manipulation under anesthesia and seriously consider the spinal blocks so long as they would be temporary. This is one of those things that conventional medicine doesn't have a reliable solution for but is still the best thing we know to do. Good luck to your friend. A joint replacement may be in the cards for her in the future. Add a complete change in your diet and skilled relaxation, and you are on your way to a complete cure.