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Pain Management

Understanding Reflex Sympathetic Dystrophy

05/06/2008

Question:

I am a phlebotomy student. 3 weeks ago a girl drew my blood and hit a nerve. I felt a shock go through my arm. The pain has lessened. However, I still have tingling in my fingers and the palm of my hand and some occasional pain. Will this get better? I have read about how this can cause Reflex Sympathetic Dystrophy.

Answer:

There have been rare cases of RSD (or more accurately, causalgia) as a result of median nerve injury during phlebotomy. The good news is that this is the exception rather than the rule. In the majority of patients who have a needle "hitting" a nerve, no RSD-like symptoms ever occur. You appear to have a good prognosis since the pain is lessening. However, early steroid (prednisone) administration as well as sympathetic blocks and occupational therapy are useful adjunct. Seeing a Pain Specialist with expertise in RSD would be helpful.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University