off label medicationsComplex regional pain syndrome is a condition in which an arm or leg has suffered an injury. For example: surgery, trauma, or stroke causing intense pain greater than one would expect in relation to the original injury. The actual cause is unknown and there is no cure. Treatment consists of pain medications, physical therapy, and biofeedback. Most of which is not very helpful. A patient came to see me recently who had wrist surgery a year ago. Shortly after surgery the patients hand would curl up and she physically has to use her other hand to open her hand. Her hand felt hot and numb and pain would shoot up her arm. Muscle aches which were very painful would come and go without warning. Her life was miserable. After a year of the pain and torture the bright and vibrant women’s mental attitude had completely changed and now she was depressed. She was not the same person she was a year ago. Her career as a pianist was gone and her future looked bleak.

With all of that her depression, her career gone, her chronic pain, and decreased use of her hand and arms she came to our office. We tried Platelet Rich Plasma (PRP) injections into her hand and arm without much success.  I suggested a prescription used in an off label use. The medical community uses this prescription on a regular basis for auto-immune disease yet if you give it in a different way instead of as an IV in the arm you get completely different results. This is called an off label use of a drug. The FDA regulates the approval of a prescription but any doctor can prescribe a prescription drug for any reason they think it is medically appropriate, virtually every prescription we have today is used for other reasons than what that prescription is used for. A lady was concerned that a beta blocker drug used for heart disease and fast heart rate was being used off label to treat her migraines with great success. Web MD in fact says that the off label use of any prescription drug can be used to treat any medical condition.

After treatment with the off label drug, this is what our patient had to say: “I am usually a very positive, happy person but it gets difficult to keep your head up when you are in pain every day with very obscure symptoms that are difficult to treat. Dr. Young offered me a shot one day when I was in the office for a PRP treatment. After a lengthy discussion with my physical therapist, I decided to give it a try! We were hoping that it would break the cycle of my nervous system telling my connective tissue system to “clamp down”. The morning after the injection, I found myself smiling and laughing at little things as I got ready for my day. I remembered that feeling of HAPPINESS – I had always been happy before I had such a difficult year with my health problems. I immediately found my husband and told him “I feel like myself today!” Over the next week I realized I had more range of motion, my hand opened more easily and I felt stronger. But beyond all of that, I felt like I had an emotional reset. I did not know that Dr. Young used the Enbrel injection for depression, so I did not know to look for that result and it was a wonderful surprise I had not expected. My hand and arm are not fully healed, but I do feel one step closer to getting to my goal: complete healing! I can open and close my hand without using my other hand to open and close it. Maybe there is hope now for a condition that the medical community says is a helpless condition.