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When do you stop with SSR?
Dear All,
Every patient I have treated to this day for an allodynia improved when we did the SSR.
Now i have one patient who is not making a lot of progress and we are allready doing the SSR for 3 months. The allodynography was very fluctuating every week (bigger/smaller). The progress she made is that the pain isn't as proximal anymore. The allodynia is in the rsnr region. Only the posterior antebrachial cutaneus nerve is also still provoking pain.
She tries to avoid any stimuli and she wears a wrist splint to prevent from alternating stimuli which gives and a constant stimulus and doesn't provoke pain.
And now my question:
What are the indicators that the SSR is also not going to work for some patients and when do you know to stop?
Kind regards,
Ellen
Every patient I have treated to this day for an allodynia improved when we did the SSR.
Now i have one patient who is not making a lot of progress and we are allready doing the SSR for 3 months. The allodynography was very fluctuating every week (bigger/smaller). The progress she made is that the pain isn't as proximal anymore. The allodynia is in the rsnr region. Only the posterior antebrachial cutaneus nerve is also still provoking pain.
She tries to avoid any stimuli and she wears a wrist splint to prevent from alternating stimuli which gives and a constant stimulus and doesn't provoke pain.
And now my question:
What are the indicators that the SSR is also not going to work for some patients and when do you know to stop?
Kind regards,
Ellen
Comments
Dear all,
Could someone find in our Somatosens Rehah e-journal the table with
the mean time and the SD of rainbow pain scale disappearance ?
Peace, Strenght and Light
CJ in Osaka (Jpn)
I found this graphic: https://moodle.neuropain.ch/uploads/editor/um/lge5ysyqbbqe.png from : Static mechanical allodynia (SMA) is a paradoxical painful
hypo-aesthesia: Observations derived from neuropathic pain
patients treated with somatosensory rehabilitation
C. J. SPICHER1,2, F. MATHIS1, B. DEGRANGE1, P. FREUND2, & E. M. ROUILLER2
In case of no progress I do the following:
1. I check wether my area for distant counter stimulation is correct, usually I have to
move the area further away from my allodynic region
2. I discuss with the Patient, wether his/her pain medication is sufficient
3. In case it is not, the Patient or I discuss the medical pain management with the
refering doctor
4. I would try to stop wearing the splint, as the stimulii for 24h might be too much for
the Nervous System
5. The next step is to think about using TENS (Transcutaneus Electrical Nerv Stimulation)
on the contralateral side
I would stop my SSR treament, if all the above didn't make a difference, meaning the rainbow area is not getting smaller.
Kind regards,
Ulla