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TENS TIPS Newsletter |
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Is RSD the Next Costly "New Wave" Workplace Disease? |
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In many ways, Reflex Sympathetic Dystrophy (RSD) is the worst of both worlds: it’s a debilitating disease that’s difficult to diagnose and treat but easy to fake, allowing many employees to approximate the symptoms. Up to 80% of patients diagnosed with RSD don’t have the disease, says Dr. Howard Sandler, president of Sandler Occupational Medicine Associates, Melville, NY. A nerve disease that usually happens after a minor injury or operation to a limb, RSD symptoms include pain inappropriate to the injury, swollenness, burning and purplish skin. In a study of 829 patients, 93% experienced pain, 91% developed discoloration of the skin, and 88% had decreased range of motion. Prevalence ranges from .01% to several percent of all injured workers. "Less than 1% of workers comp patients have RSD. Some of the numbers we are seeing are inflated." Says Dr. Steve Dawkins, with Atlanta based Occupational Health International. "The diagnosis for RSD has been around for a long time, but now people are using it out of frustration when a hand or wrist injury does not improve," he says. "It’s a misuse of the diagnosis."
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A new disease climbing the workers' compensation claims chart, Reflex Sympathetic Dystrophy, is a trauma-based, difficult-to-diagnose, and costly condition. RSD is especially dangerous because "it’s difficult to diagnose and the criteria are not as set as in other diseases," Sandler says. Employees can fake the wide-ranging symptoms. Treatment can include exercise as well as heat, contrast baths, and nerve stimulation. Anesthetics often are administered for the pain, which can be so severe patients ask for an amputation. RSD Lends itself to medical case management. Once a diagnosis is made, it’s important that treatment be fast and effective: If the condition is not identified and treated within six months, the chances of a total cure become slim, Sandler says. The total cure rate is only 33% and that drops if the disease isn’t diagnosed early. Treatment can be lengthy and it can take months to restore good functional use of the extremity. |
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Sandler pointed out that the symptoms are easy to fake and can cost employers a great deal of money, while actual cases are often misdiagnosed or not diagnosed until the possibility of a cure is greatly reduced. (Reprinted from Crawford & Company's Disability Manager Insights.) In many cases, Electromedical devices, especially High Volt Galvanic Stimulators are prescribed to aid in the reduction of pain and swelling related to RSD. Should you need to supply a patient with any such device, call CPR Medical at 1-800-235-5675 for a cost comparison.
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