Cleveland Clinic Foundation Pain Management Centers

Pain, we all experience it at one time or another to varying degrees. We seek relief using whatever is available to us. In many instances, we find nothing really works effectively. The good news is that pain management specialists devote their careers to figure out ways to help us. With locations throughout greater Cleveland, the Cleveland Clinic Pain Management specialist's offer pain management options in your own community. While pain in characterized in many different forms, there are often instances where the diagnosis is not so obvious. One such diagnosis is Complex Regional Pain Syndrome.

Poorly understood and often misdiagnosed, RSD, Reflex Sympathetic Dystrophy is characterized by varying degrees of pain, vasomotor and other autonomic disturbances, delayed recovery of function and trophic changes. According to Dr. Nagy Mekhail, Director of the Cleveland Clinic Pain Management Center, RSD actually refers to a complex disorder that may develop secondary to accidental or surgical trauma to the limbs. The later stages of RSD may lead to limb disuse and severe changes in lifestyle. RSD is a painful disorder that is classified in three stages.

• Stage I: the pain is constant and usually is described as aching or burning, often disproportionate to the injury.
• Stage II: Pain is more constant and severe.
• Stage III: There is limb atrophy and joint contractures.

Dr. Mekhail explains that RSD treatment requires a systematic approach. A sympathetic block will help diagnose and determine the pain management therapy. It is important to note that Physical Therapy and the social/psychological factors for each patient should be considered throughout any pain management program. It is also critical that the physician treating the patient with RSD has experience in pain management treatment as well as an understanding of the typical progression of therapy for RSD pain. Implantable therapy offers a nondestructive treatment alternative after more conservative procedures have failed. With proper patient selection and screening, the majority of RSD patients experience good pain relief upon implant.

An accurate diagnosis is critical to treating and managing pain. At the Cleveland Clinic Pain Management Centers, Dr. Mekhail's staff begins with an interdisciplinary evaluation that is individualized to meet the needs of each patient. Using the latest technology along with innovative procedures, the Cleveland Clinic Pain Management Centers provide a sophisticated and accurate diagnosis of pain.