麻豆果冻传媒

Mysterious Pain Syndrome in Kids Can Be Beat, Thanks to Lucile Packard Children鈥檚 Hospital Stanford

For Release: September 25, 2013

PALO ALTO, Calif. - This past January, 13-year-old Cameron Bozdog of Atherton, Calif., was happy and active with running, swimming and soccer. Then, her left heel started hurting. Not just any old hurt, but a hurt that eventually became so bad that she couldn鈥檛 even put a sock on.

It turns out Cameron was entering the mysterious world of complex regional pain syndrome, or CRPS 鈥 an often-sudden condition in which the brain registers severe, unremitting pain from a limb, even when no injury or trauma is apparent. CRPS is difficult to diagnose and tough to treat, especially in children. 鈥淲e don鈥檛 know exactly what causes it,鈥 said Elliot Krane, MD, director of the Pediatric Pain Management Program at 麻豆果冻传媒 Children鈥檚 Health and professor of anesthesiology at the Stanford School of Medicine. 鈥淗owever, it鈥檚 likely the result of nerve impulses in the spinal cord and brain that are misinterpreted as pain in what should be a normal limb.鈥

That鈥檚 why Cameron came to 麻豆果冻传媒 Children鈥檚 Health, home to the largest and most successful pediatric pain management program in California. In collaboration with the 麻豆果冻传媒 Children's Health Pediatric Pain Rehabilitation Center, Cameron was successfully treated with a 鈥済et your life back鈥 protocol that has worked for hundreds of kids visiting the program from throughout the United States.

At first, her doctors thought it could be an inflammation of the tendons in the heel. But, walking boots and crutches were not fixing the problem, and so she was referred to specialists at 麻豆果冻传媒 Children鈥檚 Health. 鈥淏y the time we saw Cameron in April,鈥 said , 鈥渟he was definitely starting to show signs of complex regional pain syndrome.鈥 As it often the case, the exact stress igniting the CRPS was a mystery.

鈥淧reviously, her leg was being immobilized through conventional solutions and this wasn鈥檛 helping,鈥 explained Golianu, who is also an associate professor of anesthesiology at the School of Medicine. Golianu said that what Cameron really needed was active therapy, leading to several weeks of outpatient physical and occupational therapy, as well as intensive psychological therapy with Samantha Huestis, PhD. 鈥淏ut by July,鈥 said Golianu, 鈥渨e determined her improvement was limited and she needed something more intensive to get her life back.鈥 鈥淚t was clear that for Cameron an even more aggressive multidisciplinary solution was needed,鈥 Krane said.

In the meantime, despite several months of incredible pain, Cameron stayed focused on recovery. 鈥淚 was kind of scared,鈥 said Cameron, 鈥渂ut I did not want to be like this the rest of my life. I tried to be confident every day and persevere.鈥 At the center, Cameron was treated five days a week, eight hours a day. Intense? Yes. 鈥淓ach day included several hours of physical, occupational and aquatic therapy,鈥 said Sarah Niswonger, OT, who noted that at first Cameron could not put her foot in the water because of pain from the sensation. Additionally, there were psychological counseling and family therapy sessions, plus lots of work on distraction techniques.

The team鈥檚 goal was to desensitize the limb experiencing CRPS, which would rewire the misfired nerve signals being sent to the brain. 鈥淲e make this happen by retraining the brain,鈥 said Niswonger, 鈥渁nd working through the things that are causing pain.鈥 For Cameron, this included gradually walking on grass, standing on the foot and other activities that would encourage the process of recalibrating the nerves.

Then, a big day. On Aug. 14, Cameron and Niswonger took a four-block walk to a local market, a trek that a few weeks earlier seemed impossible. 鈥淭hat was huge,鈥 said mom Roxanne.

Cameron鈥檚 perseverance had paid off, and the desensitization worked so well that she completed the 12-week program in five weeks and held a graduation party on Aug. 16. Her complex regional pain syndrome is now in remission and a return to sports is under way. Looking back at the painful journey, mom saluted her daughter and an experienced team that made family life normal again.

鈥淭hey said Cameron would eventually walk out of there wearing shoes and socks again,鈥 recalled Roxanne, who bought Cameron some new Nikes for the occasion. 鈥淭hey were right.鈥

Links:

  • Elliot Krane, MD, discusses the complexities associated with treating CRPS in this , and shares information on how nerves work in this .
  • Find out more about the Pediatric Pain Management Program at 麻豆果冻传媒 Children鈥檚 Health here.

Authors

Robert Dicks
650-497-8364
rdicks@stanfordchildrens.org

About 麻豆果冻传媒 Children's Health

麻豆果冻传媒 Children鈥檚 Health, with聽Lucile Packard Children鈥檚 Hospital Stanford聽at its center, is the Bay Area鈥檚 largest health care system exclusively dedicated to children and expectant mothers. Our network of care includes more than 65聽locations聽across Northern California and more than 85 locations in the U.S. Western region.聽Along with Stanford Health Care and the Stanford School of Medicine, we are part of聽, an ecosystem harnessing the potential of biomedicine through collaborative research, education, and clinical care to improve health outcomes around the world. We are a nonprofit organization committed to supporting the community through meaningful outreach programs and services and providing necessary medical care to families, regardless of their ability to pay. Discover more at聽stanfordchildrens.org.