Reflex neurovascular dystrophy
Amplified Musculoskeletal Pain Syndrome (also known as Reflex Neurovascular Dystrophy (RND) Complex regional pain syndrome (CRPS)) is a very painful neurovascular disorder. A good scale to compare this pain to other conditions is the McGill Pain Scale. In amplified pain, a very slight sensation can become unbearable pain. This is caused when there is a real pain somewhere. The message of pain goes from the nerve to the spinal cord and then short-circuits to the autonomic nerves that control the blood vessels. This leads to lack of blood flow (ischemia) so the tissues do not get enough oxygen and there is a build-up of lactic acids that lead to pain. This new pain signal is then again short-circuited to the autonomic nerves which again decrease the blood flow. This vicious cycle is how the pain is amplified.
RND can be triggered by musculoskeletal inflammatory diseases such as arthritis, injuries, or have no discernible trigger. It can be exacerbated by stress. Stress may continue to play a major role in RND even after the child has RND under control.
The treatment for amplified pain/RND is extreme physical and occupational therapy in conjunction with counseling. There are several such programs, including the Children’s Hospital of Philadelphia (University of Pennsylvania),; Boston Children's Hospital (Harvard University); The Children's Institute of Pittsburgh in Pittsburgh, Pennsylvania; The Pediatric Rehab Unit at Randall Children's Hospital at Legacy Emanuel in Portland, Oregon; Children's Specialized Hospital in New Brunswick, New Jersey, and Children's Mercy Hospital in Kansas City, MO. In a typical course of therapy, the child is put through five to seven hours of therapy a day for 2–3 weeks. This includes intensive physical, occupational, and pool and/or yoga therapy. While painful, such therapy helps to improve blood flow and breaks the amplified pain cycle. These programs have long term success rates as high as 88%[1]
Society and culture
On the February 12, 2013 Dance Moms episode titled Rotten to the Core, Dance Mom Holly revealed her daughter and dancer Nia suffers from RND. Holly revealed Nia had been pain free for two years but expressed concern over a relapse due to demands of competitive dancing.