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It’s now widely recognised that there is considerable overlap between CRPS and FND. Here, specialist Chronic Pain Solicitor Andrew Atkinson explores the theory that CRPS is a form of FND.What is FND?
A functional neurological disorder (FND) describes a situation where a person’s brain develops a problem with how it sends and receives information to the rest of the body. We often liken our brains to computers. Using that analogy, somebody with an FND has developed a software problem. There’s no damage to or other issue with the hardware (i.e. their brain).
Those developing an FND probably have an underlying psychological vulnerability. And the triggering event, whatever it is, has ‘tripped the system’, causing that software glitch. Regrettably, in the past, that’s led some people to label FNDs as being ‘all in the mind’. Fortunately, medical opinion has progressed.
What symptoms do FNDs produce?
In this short but informative YouTube video, Dr Richard Grunewald, a consultant neurologist, explains the huge range of commonly reported FND symptoms.
His description of such varied, disturbing, and ever-changing symptoms reflects my own experience of clients suffering an FND. Certainly, there’s no such thing as a ‘typical FND case’, but among the array of symptoms, common ones include:
- Walking problems
- Memory and speech problems
- Weakness
- Seizure-like events
- Tremors, jerks, or seizures
What has also struck me on occasion is that one or more symptoms experienced can relate to functions that we would otherwise perform almost unconsciously, eg walking, that now require conscious thought and effort.
Treating FND
Although symptoms can improve without treatment, a combination of psychological and physical therapies offers the best chance of improvement. Typically, treatment includes:
- Psychological: Cognitive Behavioural Therapy (CBT), antidepressants, and lifestyle changes to reduce anxiety and stress.
- Physical: Physiotherapy, occupational therapy, and pain medication.
There is considerable commonality between treatment for CRPS and FND. However, as a result of the underlying psychological vulnerability, in a typical treatment regime for FND, the balance generally tips more towards psychological therapies and medication.
CRPS vs FND
It’s now widely recognised that there is considerable overlap between CRPS and FND. Indeed, it’s now argued by some that it’s not a case of CRPS vs FND because CRPS is a form of FND. Indeed, in some cases treated initially as CRPS, better outcomes have been achieved by switching to a regime more typically used in treating FNDs, illustrating just how unhelpful rigid diagnostic labels can be.