Children's RND Program: Eliminating Pain, One Step at a Time
December 12, 2006
At the age of 12, a healthy, athletic girl suddenly suffers from so much pain in her hand that she can’t move it and won’t allow anyone to touch it.
She misses school, gives up gymnastics and spends six months going to the doctor, getting injections for the pain and trying physical therapy. Nothing works, until she comes to the Reflex Neurovascular Dystrophy (RND) program at Children’s. After three weeks of treatment, the pain is gone.
What happened in the short span of three weeks to eliminate this severe pain that had lasted for months? You might guess the patient had an expensive surgery or took a miracle drug, but actually she recovered thanks to her own hard work in our RND program.
Taking it one day at a time, she saw our Adolescent Medicine providers and did occupational and physical therapy with a team that knew just how to motivate her and just what exercises she could do to overcome the pain.
The RND program is dedicated to treating patients like this 12-year-old girl who are experiencing pain so severe they can’t participate in their normal activities.
This little-known condition, broadly defined as amplified musculoskeletal pain, may be a result of illness, injury or psychological stress. Around 80% of patients in the RND program are girls, and the average age is 12 to 13 years old.
There is no anatomical reason for the pain these patients experience - no broken arm or sprained ankle. There are potentially many factors that play a role in causing this pain, but one key factor is believed to be a problem with the nervous system, which causes an abnormal constriction of the blood vessels.
“These patients often come to Children’s after several weeks, or even months, of debilitating pain,” says Dr. Laura Richardson, director, RND program. “They have tried standard treatments for pain with no success, and their families have been searching for other options. We have had patients who come from as far away as Florida and Ontario, Canada.”
Children’s was the first hospital in the country to develop a program that consistently resolves the pain of these patients, and it is currently one of only two programs nationwide. The program uses a unique approach that involves no medications, but focuses on helping the patient overcome the pain with physical exercise, medical and psychological support.
After participating in our program, 90% of our patients have complete resolution of their pain. A small number of patients may have a relapse, but most are able to resolve the pain on their own, using the exercises they have learned in the program.
Depending on the severity of the pain, patients may participate in one of two RND programs. The first, a home exercise program, focuses on teaching patients exercises they can do at home. Patients who are unable to resolve their pain in the home exercise program or who have more severe pain participate in the other program, which is intensive.
The intensive program involves five hours of physical and occupational therapy each day, counseling with a psychologist, visits with Adolescent Medicine providers and time with Education staff to address schooling needs.
“The transformations the patients go through are incredible,” says Dr. Richardson. “When they first come for treatment, simple things like putting on their socks or showering are extremely painful. When they finish treatment, they are able to return to school, activities with friends and family, and the sports they enjoy.”