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RND can be caused by musculoskeletal inflammatory diseases such as arthritis. Reflex Neurovascular Dystrophy can not be brought on by stress; it can ONLY be AMPLIFIED by stress once RND is already present in the patient. Stress may continue to play a major role in RND even after the child has RND under control. It can relapse if the child feels depression, a lack of acceptance by society, or is injured.
The best known treatment of RND is extreme physical therapy. There are several such programs, including Children’s Hospital in Seattle, Mary Free Bed Rehabilitation in Grand Rapids, Michigan, The Children's Institute of Pittsburgh in Pittsburgh, Pennsylvania, The Pediatric Rehab Unit at The Children's Hospital at Legacy Emanuel in Portland, Oregon, and theChildren's Hospital of Philadelphia (CHOP). In a typical course of therapy, the child is put through 5 to 7 hours of therapy including intensive physical, occupational and pool and/or yoga therapy. While often painful, such therapy helps to improve blood flow and break the RND cycle. The therapy usually lasts between 2–4 weeks before the child has the RND under control. Small relapses and flare ups may occur, usually only during 5 years of the treatment, which is the average time until the child is pain free, though RND can continue to occur and may never cease.
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