June 2004

Diagnosis: Reflex Sympathetic Dystrophy

by Dr. Howard Loomis

Previously, I introduced a methodology for diagnosing difficult and problematic cases. I presented an actual case and suggested that to be a successful practitioner you must focus on locating the underlying source of symptoms, not the symptoms themselves. Sean McCaffrey, DC, of Hillsboro, Illinois, used this methodology to treat the following case.

Chief complaint

The patient is a 41‑year‑old female factory production worker suffering from severe pain in her right arm, shoulder, and hand. The pain is constant and began 3.5 years ago at work while she was pushing a washing machine. On a scale of 1 to 10 she grades the severity of the pain as an "8."

Previous treatment

The patient, with her long history of pain, has been seen by countless primary care physicians and neurologists. Eventually she was referred to Mayo Clinic where they diagnosed her condition as Reflex Sympathetic Dystrophy. Following months of treatment at this prestigious clinic, she was told her condition was permanent and she would have to live with it because medications were ineffective in relieving the pain.

Case history

This patient is 5'7" tall and weighs 161 pounds. Her only surgery was a tubal ligation at the age of 32. Otherwise, her medical and family histories are unremarkable.

Dietary survey

The woman states that she does not prepare her own meals and eats out only once a week. She usually skips breakfast, but her diet is very well balanced including plenty of fresh vegetables and adequate amounts of protein. Her only craving is fish, especially cod. In the past 30 days she has made an effort to drink three to four glasses of water a day and does not consume alcohol.

Signs and symptoms survey

A review of symptoms was quite revealing. She scored very high in symptoms relating to protein and fatty acid deficiency, biliary stasis, iron deficiency and fatigue, difficult constipation (less than one bowel movement per day), and lower abdominal discomfort. She does not use laxatives. There was a substantial amount of additional symptoms related to sympathetic dominance and, in addition to her chief complaint, she reported musculoskeletal and general arthritic symptoms.

Physical examination

All vital signs were normal. Postural analysis revealed the right shoulder was about two inches lower than the left. Her right arm hung almost lifeless at her side.

Severe soreness was reported upon palpation in the right posterior rib cage and scapula and shoulder area. The arm could not be abducted further than 10 to 20 degrees. The right hand and forearm were edematous (swollen to the elbow), cold, painful to the touch, and discolored. Right hand and finger motion was very limited, and the patient was not able to make a fist or shake hands.

In the supine position, the right foot was flared which suggested structural weakness on that side. The cervical compression test was positive, and there was evidence of poor lymphatic drainage on the right side, not just in the right upper extremity but also in the lower extremity! Craniosacral respiratory movement was locked in flexion (inhalation), compounding the lymphatic involvement.

Laboratory tests

Lateral cervical X‑rays revealed a complete loss of the normal cervical curvature. A 24‑hour urinalysis test interpretation revealed a zero reading on the Indican test. There was a noticeable lack of normal urinary sediment, especially calcium phosphate crystals. The urinary pH was acidic (5.9) and there was a lower‑than‑normal calcium excretion. Comparison of the 24‑hour volume (1800 ml) to specific gravity (1.008) suggested kidney stress and probable related low back pain and muscle contraction.

Treatment and outcome

Dr. McCaffrey first saw this patient in March of 2004. She had two subsequent visits that month. On the first visit, the doctor began enzyme supplementation to relieve the lymphatic engorgement. Nutritional supplementation was also given to support protein and fat digestion and the sympathetic nervous system.

No other treatment was given that day. Within days, the swelling was almost gone, and chiropractic adjustments were given to the upper cervical spine, right shoulder, right elbow and wrist during each of the two subsequent visits. Specific spinal subluxations were noted and adjusted at C1, C5, C6, T2, T6, T7, and T12.

Remission of pain began very quickly, and Dr. McCaffrey reported complete remission within a month. In addition, all swelling from the right upper extremity is gone, and a completely pain‑free range of motion has been restored to the right arm and shoulder. Normal grip strength has returned to the right hand.

Conclusion

Even after seeing practitioners at Mayo Clinic, being diagnosed with a permanent condition, and having to live with the pain, this patient visited a chiropractor who used his remarkable skills to relieve her pain.

Amazing, isn't it?

(Dr. Loomis welcomes input on the subjects covered in this column. For a free copy of his video "Using Enzymes in Clinical Practice: The Loomis System," and/or to make a comment or ask a question, call 800‑662‑2630 or write to him at 6421 Enterprise Lane, Madison, WI 53719. Visit www.loomisenzymes.com online for information on upcoming Loomis Institute seminars.)