Relief for Complex Regional Pain Syndrome Following Dog Attack

David Guerrero was walking to a bus stop when a dog attacked him. He was rushed to the emergency department at St. Luke’s University Hospital in Bethlehem where he underwent surgery on his left hand and was treated for wounds on his right wrist and left calf.

The dog did severe damage to David’s left hand. He and his healthcare team say he has permanent disability. “I’m a righty, thank God,” he said. David has been working with Scott Loev, DO, medical director for St. Luke’s Spine and Pain Associates, to manage his chronic pain.

David recently completed occupational therapy at Physical Therapy at St. Luke’s North in Bethlehem. It was a huge milestone that has helped him regain movement and some function in his left hand, including the ability to make a fist. However, pain set in, later identified by Dr. Loev as Complex Regional Pain Syndrome (CRPS).

“There are no specific tests to diagnose CRPS,” Dr.  Loev said. “Diagnosis is made during a physical examination based on a list of common signs and symptoms such as color change, swelling, and nerve pain.”

CRPS can occur, Dr. Loev said, after a forceful trauma to an arm or leg, including a crushing injury or a fracture. David sustained both from the attack. Dr. Loev has administered four sympathetic nerve blocks to a collection of nerves called the stellate ganglion to stop the pain. David said the first shot “did nothing,” but he noticed improvement after the second shot and even more improvement after the third and fourth shots. He’s currently between zero and one on the pain scale.

David, who works for Mack Trucks, has been on disability since his attack. Despite his incredible progress and improvement in his pain, he is still disabled in his hand. “It might be a big career change,” he said.

He credits his progress to his St. Luke’s team.