Injured worker suffering knee pain from reflex sympathetic dystrophyI’ve written before about clients suffering from reflex sympathetic dystrophy (RSD, aka complex regional pain syndrome), a devastating condition that results from relatively minor injuries, causing profound pain and disability.

Thirty years ago, much like carpal tunnel syndrome, RSD was considered a controversial diagnosis; doctors and the Ohio Bureau of Workers’ Compensation (BWC) were split on whether the condition was legit. Some thought it was “all in your head” or just something doctors diagnosed when they couldn’t figure out “the real problem.” Such thinking also led to wholesale denial of treatment requests. Whereas spinal cord stimulators and morphine pain pumps are recognized as proper treatment today, they were considered experimental back in the day and routinely denied.

The first client I recall breaking through the approval barrier is Chris C. (An alias has been used per request.) Chris was an attorney representing Ohio in multimillion-dollar utility cases. She became a client after suffering what seemed to be a fairly minor injury: She tripped getting into an elevator at work that stopped 2–3 inches above floor level, falling and bruising her knees. Though she remained at work, she rapidly developed significant pain in her knees that spread to other areas of her body. She worked at home for a couple of months and intermittently had arthroscopies with shaving of both patellas, epidural blocks, and bilateral lumbar sympathectomies (cutting a nerve to relieve pain). She became extremely sensitive to light and required enormous amounts of opioid pain medicine with little relief.

Ultimately, a pain specialist and her orthopedist (one of the finest in the state) requested the BWC approve a pain pump. Initially denied, we won on appeal, and the pain pump was installed over 20 years ago. She’s required several replacements since then. While Chris could not return to any work despite her high level of education — we succeeded in having the Industrial Commission award her permanent total disability — she improved to the point of enjoying some quality of life again. She’s a member of several online support groups for people suffering from RSD, and she encourages all of them to seek medical attention and find help for their condition. She’s a great inspiration as she continues moving forward one day at a time.

James Monast
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Board-Certified Workers’ Compensation Attorney in Columbus, Ohio