Cannabidiol (CBD) – ‘Cannabis With the Fun Bit Taken Out’ – For Severe Chronic Pain

Feature Image sourced from:

Dear Pain Matters blog readers,

Today’s blog post will focus on a particular cannibinoid molecule called cannabidiol (CBD).

Cannabidiol offers many medicinal benefits including pain relieving, anti-inflammatory, antioxidant and neuroprotective benefits.

Contrary to widespread belief, cannabidiol (CBD) treatment results in NIL psychoactive effects.  Hence it is impossible to get ‘high’ on cannabidiol (CBD) alone.  Some people even jokingly refer to cannabidiol (CBD) as ‘cannabis with the fun bit taken out’.


The cannabis plant species (that includes marijuana and hemp plants) comprises a minimum of 113 different phytocannabinoids (ie cannabinoids).  These cannabinoids act on cannabinoid receptors throughout the body and brain.  These include a non-psychoactive molecule, cannabidiol (CBD), as well as a psychoactive component, tetrahydrocannabinol (THC).  

Different cannabis plant species (ie marijuana and hemp plant strains) offer different CBD:THC ratios.  For example, industrial hemp contains less than 0.3% THC levels.

It is important to note that when isolated, the CBD molecule is the same, regardless whether it is isolated from marijuana or female hemp.  As such, CBD (in its purest molecular form) does not exert any hallucinogenic effects, regardless of its source.   

Quoting Franjo Grotenhermen, International Association of Cannabinoid Medicines:

“CBD is CBD. The human body does not care where the molecule comes from.


Diagram of the CBD molecule is sourced from:

Cannibidiol use does not lead to addiction and there is virtually nil toxicity (hence minimal side effects).  Cannabidiol is well tolerated and can be taken alone or with other medications (with nil CBD-attributable side effects).  Inclusion of CBD in pain management can lead to reduced intake or complete cessation of other pain medications (hence reducing or eliminating all of their adverse effects).

Cannabidiol can reduce ongoing pain in arthritis, rheumatoid arthritis, nerve pain, cancer pain, back pain, knee pain, fibromyalgia and other debilitating chronic pain conditions via its strong anti-inflammatory and other biological effects.  

Not only does cannabidiol promote relaxation and calmness, but it may also alleviate certain symptoms of insomnia, menstrual pain, depression, mood problems, anxiety, fear, post traumatic stress syndrome (PTSD) and Parkinson’s disease (including significant reduction of tremors as well as improved swallowing and talking) (Barton, 2017).  Cannabidiol may ameliorate chemotherapy-induced nausea and vomiting, spasticity, epileptic seizures as well as certain symptoms of multiple sclerosis (MS) and Alzheimer’s.  Cannabidiol may be a useful adjunct to palliative care.  

Cannabidiol’s neuroprotective and other biological effects are invaluable following a stroke (Hayakawa et al, 2010), bone fracture (Kogan et al, 2015) or against Paclitaxel-induced neurotoxicity (Likar and Nahler, 2017).  A CBD-based study is currently underway to investigate CBD’s potential effects on malignant brain tumours in children.  This study was inspired by a 4-year old boy whose potentially fatal brain tumour shrunk by 66% after being given CBD and going on a low carbohydrate (ketogenic) diet (Grundy, 2017; Marsh, 2017; Waugh, 2017).   

Adult-Onset Still’s Disease (AOSD)

Excess levels of the pro-inflammatory cytokine IL-1β play a major role in Adult-Onset Still’s Disease (AOSD), a systemic autoimmune disease that often presents with persistent high spiking fevers, joint pain and salmon-colored bumpy skin rashes.  Recent treatments of AOSD include Canakinumab and Rilonacept (ie IL-1β blockers) (Giampietro and Fautrel, 2012).  

A study showed that when mice with MS-like symptoms were treated with CBD, they had decreased IL-1β and other pro-inflammatories (compared to mice who did not receive CBD treatment) (Mecha et al, 2013).

A question: Would CBD treatment that strongly inhibits IL-1β and other pro-inflammatory cytokines in mice similarly benefit AOSD patients (where excess IL-1β levels also appear to be a problem)?  If yes, what CBD dosage would be effective?  Investigation may be warranted.    

How to Use Cannabidiol (CBD)

Cannabidiol products are available as capsules, tinctures, infused edibles, syrups, teas, chewing gum, extracts, isolate and topical creams and ointments (that allow CBD to be directly absorbed through the skin).  Each product has its own method of dispensing (eg. via ingestion, inhalation via vapourizer or e-cigarette).  To obtain the full benefits of CBD, one should always read the instructions.  


Cannabidiol is also available as CBD oil that can be sublingually applied.  Sublingual application of CBD involves the placement of multiple drops of CBD oil under the tongue.  This allows CBD to be quickly absorbed into the bloodstream via the mucous membrane in the mouth, thus bypassing the digestive system and liver.


Photo sourced from:

Some CBD products are more effective than others, depending on CBD purity (see next section involving the Austrian study for a discussion on CBD purity).  Extraction methods, plant strains and application methods may also influence CBD’s effectiveness.  

Correct dosages are important.  Dosages may have to be titrated until therapeutic benefits including pain relief are achieved.    

The application of CBD oil is somewhat similar to that of cannabis-derived Sativex (Nabiximols), although the latter is sublingually applied via mouth spray.  There is one crucial difference between CBD and Sativex, being that Sativex comprises both CBD and THC, roughly on a 1:1 ratio, while CBD oil comprises negligible amounts of THC.

Note: Sativex was also discussed in 2 earlier blog posts:

and here:

A CBD-Based Medical Study in Austria

The Study

Prof Dr Rudolf Likar, MSC, performed a study involving 9 severe pain patients in Austria.  Four patients were unable to complete this study for various reasons, while the remaining 5 patients completed the study. 


Prof Dr Rudolf Likar, MSC

Head of Anaesthesiology and Intensive Medicine, Klinikum Klagenfurt, Austria

General Secretary of Österreichischen Schmerzgesellschaft (ÖSG; Austrian Pain Society)

Photo sourced from:

The severe pain patients in Dr Likar’s study were offered 2 ‘200 mg CBD’ capsules, twice a day after meals (one in the morning and one at night, totalling 400 mg CBD daily), in addition to their usual medications.  

Made by a pharmacist in Velden, Austria, the CBD capsules contain CBD in its purest form (purity exceeding 99.5%) that has been isolated from industry hemp grown in the UK.  Pure CBD, in its crystalline (powder) form, is dissolved in hemp oil and heated up to temperatures not exceeding 50 degrees C (to preserve CBD’s bioactivity) (Likar, 2016; also see the excellent video in German, below, from 2:30 minutes on).    

The 5 patients including 3 males were aged 49 to 79.  Three patients had cancer (multiple myeloma, urothelial carcinoma and breast cancer), one patient (49) had fibromyalgia and one patient (52) suffered various painful conditions including brachialgia, cervico-cephalgia, thalamic pain and dental pain.

After 1 month of CBD treatment, the urothelial carcinoma patient (53) no longer suffered any pain.  Post-CBD, he stopped taking Fentanyl patches, Neodolpasse, Vendal and Lidocaine infusions.  His pain was completely managed via CBD and 150 mg Lyrica/day (down from 300 mg Lyrica/day).

After 4 months of CBD treatment, the fibromyalgia patient (49) enjoyed significantly less pain (from VAS = 8 to VAS = 3).  She was able to reduce her Oxygerolan medication by 33% as well as stop all her other pain medications.  

After 6 weeks of CBD treatment, the breast cancer patient (74) no longer had nausea and was, for the most part, pain-free.  Her Hydal intake was reduced by 33% daily and all her other pain medications were stopped.

After only 1 week of CBD treatment, the multiple myeloma patient (79) enjoyed pain reduction from 9 to 6 (VAS) and was consequently able to reduce his Lyrica intake.  His quality of sleep also improved.

After 2 months of CBD treatment, the patient with several painful conditions (52) had reduced pain levels and better quality of sleep.  She was able to reduce some of her medications. 

In summary, there were no psychoactive effects nor side effects resulting from the CBD treatment.  There was no risk of addiction and the CBD treatment was well tolerated as a co-medication (Likar, 2016).     


In order to derive optimal medicinal benefits from CBD treatment, it is perimount that CBD (in its purest form) be offered on a 20:1 ratio (or greater) with THC.  Otherwise, there is a risk that CBD’s unique effects including pain relief may not occur (due to ‘CBD underdosage’) (Likar, 2016).

In comparison (as noted in the Introduction), Sativex comprises relatively equal amounts of CBD and THC on a ~1:1 ratio.  Precisely, each 100 microlitre spray contains 2.5 mg CBD and 2.7 mg THC (ie CBD and THC on a 1.00:1.08 ratio) (plus up to 0.04 g alcohol).

Dr Likar noted that in the presence of an equal amount of THC, CBD underdosing may result – that may lead to reduced and/or nil CBD-induced pain relief.  Thus, a significantly higher CBD to THC ratio (for eg, 20:1, or greater) is a prerequisite before CBD’s unique medicinal benefits can be optimally achieved (Likar, 2016).

The following YouTube (in German) includes interviews with Prof Dr Rudolf Likar and several pain patients:

Here in this video, Dr Likar noted that some pain patients may require daily CBD dosages up to 400 mg – 600 mg (half in morning and half at night) to derive optimal pain relief (refer to 2:25 minutes), while others may not benefit from CBD treatment.

Anecdotal Case Studies   

(1) Laura Bryant of Australia – Cannabidiol (CBD) Oil for Severe Arthritis Pain Including Ankylosing Spondylitis 

Laura Bryant (20) from Canberra, Australia, suffers from severe arthritis including painful ankylosing spondylitis.  Stress (eg due to university studies) and cold weather are enough to bring on flares, painful joints, aching hands and feet as well as skin blotches.  At times her pain is so bad that she relies on an elbow crutch for mobility.  


Laura Bryant (20) at home in Canberra, Australia (2015) 

Credit: Jay Cronan, Fairfax Media/The Canberra Times

Prior to discovering the pain-relieving benefits of CBD oil for her painful ankylosing spondylitis, Laura used to ingest a fistful of pills, crawl into the bathroom and soak in a hot bath for 2 hours while waiting for the stabbing, knife-like, pain in her back and hips to finally ease up just a bit.  On a good day, she would finally be able to leave her room just in time for a 20-30 minute lunch (assuming that she could eat in the first place due to all the pain pills that messed with her appetite).  After lunch, her mother had to help her back into bed where she had to lie horizontal due to excessive pain.  Laura spent entire days and weeks watching television.  It was simply too difficult to read given all the pills that she was taking.  This routine continued for 3 years as her ankylosing spondylitis worsened.

One day, she counted 28 daily pills including Oxycontin!  ‘Wow, 28 pills every day?’, she thought to herself.  There were pills for breakfast, lunch and dinner.  In fact, there were so many pills that they made her sweat turn orange.  Her appetite suffered drastically.  The worst part of this story was that her daily cocktail of 28 pills did not even effectively manage her severe pain!

Laura endured more than 10 hospitalizations due to excessive pain.  Laura even fainted on the hospital floor due to excessive painful stabbing in her vertebra.  Despite this, she would rate her pain as ‘only a 7’.  This is because she feared that if she rated her pain levels any higher, they might accidentally overdose her on morphine again.  She feared being in a wheelchair again with tubes coming out of her nose.

Laura tried many pain treatments including a treatment involving a 30 cm-long spinal needle with a 45 degree bend.

One day, her specialist said to her (after discussing her ongoing cortisone and biological injection treatment protocol):

“If this doesn’t work, I’m afraid this is pretty much it … You’re on everything we can give you.  There are no more treatment options … I’m afraid, I’ve run out of options … This is going to be your life.”

Laura sobbed after hearing her hopelessly grim, long-term prognosis from her specialist while her dedicated parents looked on helplessly.

Depression soon set in.  She would stare at her Oxycontin pills and think:

“Why not just take a couple of extra and be done with it?”

One sad day, Laura begged her mother, Bernadette, to ‘put her out of her misery’ and ‘help her end it all’.

On another day while driving to Sydney with her family, doubled up in pain in the back seat of the SUV, Laura wailed out in pain,

“I don’t want to do this anymore.  I can’t do this.  I can’t do this!”

Laura’s 16-year old brother tried to comfort her in the back of the SUV by saying, “It’s going to be OK.”  But even he could not stop his own tears from streaming down his face.  Bernadette quickly stopped the vehicle to a safe side of the road.  It was pouring rain and dark outside.  Regardless, Bernadette hurried outside to the back of the SUV to locate the Valium that would sedate Laura as quickly as possible, all the while listening to her daughter scream out, “Just give them to me!”  

Seeing her daughter in so much pain, suffering and agony was almost too much for Bernadette to handle…

Warning:  Under-treatment of severe chronic pain often leads to thoughts of suicide, and Laura was certainly no exception.  Sadly, many who despair due to excess pain actually do go through with suicide.  Clearly, timely access to effective pain treatment options (whether this is CBD or another pain treatment option) is paramount.   

Finally, A Trickle of Hope Turns Into A Tsunami of Pain Relief

One day while lying in bed, a television show appeared about a Colorado-based company called Charlotte’s Web.  This company offered a strain of cannabis that promised low-psychoactive effects.  The show added that some arthritis sufferers were now obtaining relief from this strain of cannabis.

Wasting no time, Laura immediately emailed the company, Charlotte’s Web:

“… I’m in Australia … can you give me any advice or put me in touch with people here? I’m desperate.”

Several weeks later, Laura received her first supply of CBD oil.  Laura’s daily pill intake was reduced shortly afterward, as was her time spent in bed and in the hot bath.  Within 2 weeks, her pelvis became less stiff.  Consequently, she no longer needed her long, hot baths and she removed her shower chair and toilet aids from the bathroom.  She also started eating breakfast at a normal time.

Laura started working out with a personal trainer each week.  One day, she started playing Oztag.  Another day, she was finally strong enough to take her nephew to the park to play … and her sister was so overwhelmed that she cried with joy.  Laura even started dreaming about her life goals and travel plans again.

Laura now uses several drops of CBD oil under her tongue every morning to manage her painful ankylosing spondylitis.  Laura states,

 “[Medicinal cannabis] has given me my life back [after years of severe pain] and doctors aren’t recognising it” (Hannaford, 2015; Brown, 2016).

For more details, please read:

This article also includes an excellent 4-minute video called ‘Forbidden Healing’ (Credit: Jay Cronan, Fairfax Media, 2015).

(2) Hope Bobowski of Canada – Cannabidiol (CBD) Oil for Severe Osteoarthritis Pain in Back  

Hope Bobowski (79) of Keremeos, BC, Canada, is spreading her own very special message of hope and joy around.  Until June 2016, Hope suffered from severe osteoarthritis pain in her back.  Her pain was so severe that her husband had to assist her to and from bed, dress her and take over the cooking.  In her words,

“I was going downhill fast.”

Hope was taking 4 – 6 ‘Tylenol 3’ codeine-containing pills daily for her intense osteoarthritis pain.  When her GP suggested trying opioid painkillers, she was worried about becoming addicted.

In June 2016, after her husband located CBD oil from an unlicensed producer, Hope tried her very first spoonful of CBD oil.  Guess what happened next??  Only one day after taking 10 drops of CBD oil, she had nil pain in her back!  In her own words,

“There was no pain.”

Since taking her daily spoon of CBD oil just before going to sleep, Hope was able to cease taking all pharmaceutical painkillers.  Hope has nil psychotic effects from the CBD oil due to its virtual absence of THC.  Best of all, Hope no longer suffers from back pain and is now able to sleep without leg cramps.   

Thanks to her daily dose of CBD, Hope was able to return to gardening, card games and cooking for her beloved great-grandchildren.  Life could not be better for Hope (Barton, 2017)!   


Image of Hope Bobowski with her beloved grandchildren

Credit: Jeff Bassett, The Globe and Mail


Image of Hope Bobowski at home in Keremeos, BC, Canada, on April 2017

Credit: Jeff Bassett, The Globe and Mail

(3) Deryn Blackwell of the UK – Cannabis Tincture for Severe Cancer Pain 


Image of Deryn Blackwell with his devoted mother, Callie  

Credit: This Morning/Youtube  

Deryn Blackwell underwent chemo- and radiation therapy following his diagnosis of leukemia in 2010 (when he was only 10).

Two years later, Deryn (by then, aged 12) was also diagnosed with Langerhans cell sarcoma, a very rare form of cancer with very poor prognosis.  Deryn’s treatment for Langerhans cell sarcoma included countless additional chemo- and radiation therapies, 3 failed bone marrow transplants plus a 4th (and final) bone marrow transplant. 

On Day 46, post-4th transplant, and believing that he was terminally ill anyway, Deryn decided that he no longer wanted to live anymore.  After all, he had already undergone 4 years of treatment, he was very sick and in a lot of pain (despite painkillers including morphine and fentanyl), he hadn’t been able to eat for 7 months, his mouth was covered in blisters, he could not swallow and his body had wounds that were simply not healing.

Deryn even went so far as to plan his own funeral.  However, Deryn’s mother, Callie, was not ready to give up on her son yet …    

While his cancer was successfully eradicated, his immune system was now severely compromised.  According to his mother, without antibiotics, morphine and fentanyl, Deryn would only be able to survive 3 – 7 days at best unless Deryn’s 4th bone marrow transplant finally succeeded.  Unfortunately on Day 70, his blood tests still showed ‘nothing in his bone marrow’, indicating that his 4th transplant was failing.  Deryn was running out of options and his prognosis did not look good.  

Enter Cannabis Tincture …

By  now, Callie had read a lot about the medicinal benefits of cannabis oil.  She asked the doctor to add Bedrocan, a cannabis-based pain reliever, to Deryn’s hospital medication.  The doctor said that she was unable to do this as Bedrocan was not licenced for children in the UK.

Desperate and completely out of (legal) options, Callie gave a cannabis tincture under the tongue (sublingually) to Deryn for the first time at the end of Day 70 (with Deryn’s consent, but without the doctor’s knowledge).  After all, Callie thought, what did she have left to lose?  Her son was dying anyway.

Guess what happened next??

Within only 30 – 60 minutes of his first cannabis oil treatment, Deryn felt completely relaxed for the first time in a long time.  His anxiety had stopped.  Five (5) days later on Day 75, his overall health and well-being had improved significantly including his wounds on his injured fingers that had disappeared altogether within a mere 5 days.  The now-healed wounds on his fingers had been bandaged only 5 days earlier, on Day 70 – the same day when his blood tests still showed absolutely ‘nothing in his bone marrow’.

In her opinion, Callie’s decision to secretly add cannabis tincture to Deryn’s treatment protocol on Day 70 was the key turning point for Deryn.  It was the cannabis tincture that had (somehow) stimulated the 4th failing bone marrow transplant into finally becoming a success. 

And now, thanks to the cannabis tincture, Deryn is finally 100% painfree and healthy.

To celebrate this significant milestone, Callie wrote a book called ‘The Boy in 7 Billion’ (available in Amazon).

Here’s the video link dated 27 March 2017:

Credit: This Morning/Youtube

(4) Other Comments and Testimonials About CBD 

Phil Schwarz 

Born in Scotland, Phil Schwarz (82) suffered painful rheumatoid arthritis (pain levels up to 7) for many years.  One day a family member encouraged her to try CBD (nicknamed ‘cannabis with the fun bit taken out’) for her severe pain.  Phil started taking two 15% raw hemp oil drops, three times a day (without changing her other medication).  Quoting Phil:

“So the first time I took some was at night time before I went to sleep. The next day I was out of bed like a spring chicken and I’ve been pain free ever since’  ‘I’ve just been out and I’ve walked about ¾ of a mile’ … ‘before I couldn’t do about a hundred yards. It’s like a miracle worker, and I don’t care if it’s in my head or in a bottle, whatever it is, it’s doing it”.

For the story, please click:

CBD Made Me Pain Free, Now I’ll Have to Break the Law to Get It

Wendy Primeau

Wendy Primeau suffered fibromyalgia, Lupus, rheumatoid arthritis and a painful and deteriorating spine.  She took Hydrocodone for almost 5 years, and occasionally, she also took Vicodin, Roxicet and Perkicet.  Only 6 hours after trying a high dose of CBD oil, she was pain-free.  Quoting her:

“My husband was worried, and asked me said what was wrong. I just kept crying because I was so happy, I couldn’t believe it, but I was pain free for the first time in YEARS.

David Wells

David Wells, a former pitcher in Major League Baseball, has endured many painful episodes over his career.  He tells his story here:

Other Stories

For more stories, see:

Quoting ‘Peter’ on 9 February 2018:

Buy it over the internet. I had 7 vertebrae fused in my neck 3.5 years ago, which popped up as a problem when my lower back was so bad that after 20 years of drugs, injections, and booze I was ready to get that operated on. Was in agonizing lower back pain in addition to the post-cervical operation pain. Two sprays under the tongue and 5 minutes later [pain] was gone. Haven’t even taken an Advil since, stopped drinking too. I spray twice a day, and when I don’t, pain comes back after a couple days, so I know it is working. No side effects whatsoever!”

Here is another link describing many pain patients’ experiences with CBD (in German only, for German readers):


Peer-Reviewed Science Papers

So what does the science say about CBD for pain and inflammation?

A study found that decreased leukocyte (white blood cell) migration was observed in the injured lungs of CBD-treated mice for up to 4 days following lung injury.  A reduction in leukocyte migration into these lung regions resulted in less leukocyte activation as well as reduced pro-inflammatory mediators including TNF and IL-6 in CBD-treated mice.  This can lead to lower tissue damage and enhanced tissue regeneration.  It is likely that CBD’s anti-inflammatory effects occur via enhanced adenosine release as well as increased signaling via the adenosine A2A receptor (and other biological mechanisms).  Other studies showed that CBD can decrease the production and release of IL-1β and IL-6, together with other anti-inflammatory effects (Ribeiro et al, 2012; Pisanti et al, 2017).

Mice with MS-like symptoms that underwent CBD treatment had reduced IL-1β and other immunoregulatory actions, and that this likely occurred via increased A2A adenosine receptor signalling (Mecha et al, 2013; Pisanti et al, 2017).

Another animal study found that transdermal CBD decreased inflammation and pain behaviours in rats with arthritic-like symptoms.  Specifically, there was a dose-dependent reduction in pro-inflammatory cytokines including TNF (up to an optimal dose of 6.2 mg CBD/day for 4 days).  The rats did not display any psychoactive effects.  The results of this study suggest that topical (skin) applications of CBD may offer localized pain relief and reduced inflammation with minimal side effects in arthritis patients  (Hammell et al, 2016).

Further details pertaining to medicinal cannabis including CBD are available in many papers (Likar and Nahler, 2017, and other science papers).

Many videos on CBD also exist including this YouTube link (in English, with German subtitles):

Is Cannibidiol (CBD) Oil Legal in Australia?  

A friend with back pain just asked me where he could legally buy CBD oil in Australia.  This section tries to answer his question as best as possible:

First, the good news:

Yes, in theory, CBD oil is now legal in Australia.  Cannabidiol is now listed as a ‘Prescription Only Medicine’ in Australia.

Specifically, after 1 October 2017, CBD Oil (Full Spectrum CBD Oil Extract) was classified as a ‘Schedule 4 – Prescription Only Medicine OR Prescription Animal Remedy’.  Thus, assuming you can find a doctor who will prescribe CBD oil, it is now legal.  

And now, the bad news:

There may only be 23 Paediatric Neurologists in all of Australia who are actually authorised to prescribe to children with neurological conditions.  (Don’t quote me on this one though.)

If this is true, what can the adult chronic pain patients in Australia do if they would like to legally obtain the non-pyschoactive and non-addictive CBD oil for pain relief??

Chronic pain is a serious issue.  It is one thing to legalize CBD oil.  It is another thing to then unnecessarily delay legal access to it, for whatever reasons.  The current situation is simply unacceptable.  More has to be done to ensure that chronic pain patients in Australia can obtain a prescription for CBD from their doctor, should they wish to do so.  For the sake of chronic pain patients all across Australia, this issue needs to be sorted out as a matter of highest priority.  

For more information, please refer to:

Is Cannabidiol (CBD) Oil Legal in Australia? (updated Feb 2018)

Please read the following section for Switzerland’s approach to CBD

Switzerland and Cannabidiol (CBD)

In Switzerland, chronic pain patients no longer have to obtain a medical prescription to buy CBD as long as it contains less than 1% THC.  After all, the Swiss authorities acknowledge that psychoactive effects can not arise in the first place if THC content is less than 1%.  Furthermore, because CBD does not compromise mental clarity, it does not increase the risk of falls in seniors.  Equally important, the Swiss authorities accept that (unlike opioids), CBD is not addictive. 

Cannabidiol legalization helps to remove the stigma and adverse social consequences related to its use.  People who use CBD for medicinal purposes only are often mistakenly accused of simply wanting ‘an excuse to get high’.  In actual fact (as already stated), CBD has nil psychoactive effects.    

By allowing CBD containing less than 1% THC to be legally available without a prescription, greater pain treatment options are now available in Switzerland. 

A question:

Why are there so many diverse approaches to the legalization of CBD between different countries?  Can we learn anything from Switzerland, Austria and other countries whose pain patients are able to legally access CBD, with or without a prescription, more easily than in Australia?  Finally, are we doing the best that we can for pain patients in Australia?  If not, why not??  


Some doctors believe that CBD’s medical benefits are ‘purely anecdotal in nature’ and that more CBD research is needed.

However, there is a growing number of medical practitioners that recognize CBD’s medicinal benefits including pain relief.  Daily CBD use does not result in any psychoactive effects (given its virtual absence of THC), tolerance nor other adverse effects.

Many patients including Laura Bryant, Hope Bobowski and Deryn Blackwell say that, based on their own personal experiences, they have all the evidence they will ever need that CBD offers effective pain relief for their chronic pain.  

In Hope Bobowski’s words,  

“I’m spreading the word.”

In Laura Bryant’s words (quoting),

“The medical system failed me.  The hospitals failed me.  There are medical journals out there supporting the use of medical cannabis.  Why did I have to get to the point where my mother had to sedate me on the side of the road and my little brother had to go through that?  Why did I have to get to the point where I didn’t want to live anymore when there is a medication out there that has changed my life but I’m not supposed to have it? … 

I want to show the sceptics that I am not some 20-year-old stoner with no job.  [CBD oil has] given me my independence back.  I didn’t have to go through that guilt!”

” … this is a medicine and … it has given me my life back.  I want them to know that without it, I will go back to the way I was, and even if my condition isn’t life-threatening, the side effects of it are.

While CBD (containing less than 1% THC) may not work for everyone, the first and foremost step is to allow legal access to CBD in the most acceptable, practical and expedient manner possible.  Switzerland, Austria and other countries have paved the way for pain patients to legally access CBD (with negligible THC content) via prescription or otherwise.  It is hoped that many more countries will find a humane and compassionate way to help ease the pain and suffering of its patients by offering as many pain treatment options as possible including CBD.

NB Please obtain proper medical advice and ensure compliance with local laws before using medicinal cannabis including CBD oil.


Here’s to Laura, Hope, Deryn and many other patients for sharing their inspiring stories that offer hope to other pain patients.

In Laura’s words, 

“…there is hope.  I want them to know not to stop trying.”

Thank you, Laura, Hope and Deryn for spreading hope!

Sabina Walker

Blogger, Pain Matters (in WordPress)


In English


(1) Hoffman, Andy. A Swiss Startup Is Pumping Out Legal Hashish. Bloomberg (8 December 2017).

(2) Swiss Oasis for Legal Cannabis, Without the High. The Local (14 April 2017).

(3) Killalea, Debra. AAP (22 February 2017).

Medical Marijuana Legal in Australia: What It Means for You

(4) Calvo, Amberley. How Does Cannabidiol (CBD) Work? Elixinol (19 August 2015).

(5A) Marsh, Sarah. Study Looks at Cannabis Ingredient’s Ability to Help Children’s Tumours.   UK Research into Cannabidiol (CBD) Comes After Surge in Parents Administering it to Children Without Medical Advice. The Guardian (3 May 2017).

(5B) Waugh, R. Four-Year-Old Brain Cancer Patient Sees Tumour Shrink – Thanks to Cannabis Oil. Metro News (3 May 2017). 

Four-year-old brain cancer patient sees tumour shrink – thanks to cannabis oil

Anecdotal Case Studies

(6) Barton, Adriana. The Globe and Mail (20 April 2017).

(7A) Hannaford, Scott. The Canberra Times (2015).

Pain, and a Future on Hold

(7B) Brown, Andrew. The Canberra Times (29 October 2016).

Medicinal Cannabis Now Legal After Law Change Comes Into Effect

(8) Hussain, Danyal. Mother Who Gave Her Dying Son Cannabis to Ease His Cancer Symptoms Says It’s Saved His life And HERS After She Used It To Treat Her Depression. Daily Mail (4 February 2018).

Medical and Science Papers

(9) Hammell DC, Zhang LP, Ma F, et al. Transdermal Cannabidiol Reduces Inflammation and Pain-Related Behaviours in a Rat Model of Arthritis. European Journal of Pain (2016); 20(6): 936-948.


(10) Mecha, M et al. Cannabidiol Provides Long-Lasting Protection Against the Deleterious Effects of Inflammation in a Viral Model of Multiple Sclerosis: A Role for A2A Receptors. Neurobiology of Disease 59 (11 July 2013); 141–150.

(11) Ribeiro et al. Cannabidiol, A Non-Psychotropic Plant-Derived Cannabinoid, Decreases Inflammation in a Murine Model of Acute Lung Injury: Role for the Adenosine A2A Receptor. European Journal of Pharmacology 678 (12 January 2012); 78–85.

(12) Pisanti et al. Cannabidiol: State of the art and new challenges for therapeutic applications. Pharmacol Ther. (July 2017);175:133-150.

doi: 10.1016/j.pharmthera.2017.02.041.

(13) Giampietro, C and Fautrel, B. Anti-Interleukin-1 Agents in Adult Onset Still’s Disease. International Journal of Inflammation (2012), Vol. 2012, Article ID 317820, 6 pages. doi:10.1155/2012/317820

(14) Likar, R, Nahler, G. The Use of Cannabis in Supportive Care and Treatment of Brain Tumor, Neuro-Oncology Practice (1 September 2017); 4(3): 151–160.

(15) Hayakawa K, Mishima K, Fujiwara M. Therapeutic Potential of Non-Psychotropic Cannabidiol in Ischemic Stroke. Pharmaceuticals (2010); 3(7): 2197-2212. doi:10.3390/ph3072197.

(16) Kogan et al. Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts. J Bone Miner Res. (30 Oct 2015); (10):1905-13.

doi: 10.1002/jbmr.2513.

(17) Grundy, R. New Research to Test Effect of Cannabidiol on Child Brain Tumours. Children’s Brain Tumour Research Centre, University of Nottingham, UK (2 May 2017).

(18) A Safety Study of Sativex Compared With Placebo (Both With Dose-intense Temozolomide) in Recurrent Glioblastoma Patients. Identifier: NCT01812616.

In German


(1) Die Schweiz im Cannabis-Light-Rausch: So Professionell Läuft das CBD-Geschäft. Watson (26 November 2017)–So-professionell-laeuft-das-CBD-Geschaeft

(2A) Likar, Rudolf.  Cannabidiol: Schmerzreduktion bei Therapieresistenten Fällen.  Universum Innere Medizin (2016); 08/16: 96-97.

(2B) Cannabis-Inhaltsstoff CBD Hilft Bei Schmerzen. Kaernten News (20 January 2017).

(2C) Kofler, B. Hanf-Inhaltsstoff Cannabidiol Dämpft Schmerzen Ohne Effekt Auf Gehirn – Hinweise Auch Auf Entzündungshemmende Wirkung. B&K (20 January 2017).

(2D) Cannabidiol: Schmerzlindernd ohne Nebenwirkungen. Der Standard (20 Jänner 2017).

Medical Paper

(3) Likar Rudolf. Cannabidiol: Schmerzreduktion bei Therapieresistenten Fällen. Universum Innere Medizin (2016); 08/16: 96-97.

Anecdotal Case Studies

(4) rpw. Weil Nichts Mehr Half – Mutter Verabreichte Ihrem Krebskranken Sohn Heimlich Cannabis. Stern (28 March 2017)


Thanks To Dr Katinka’s Non-Invasive Treatments, Many CRPS Patients Are Enjoying Significant Recovery From CRPS

Dear Pain Matters blog readers,

As mentioned in earlier posts, Dr Katinka van der Merwe (aka Dr Katinka), a Chiropractor at The Neurologic Relief Center, Arkansas, USA, specializes in chronic pain including complex regional pain syndrome (CRPS).  Dr Katinka’s novel and non-invasive approach focuses on restoring balance in the autonomic nervous system, with particular emphasis on the vagus nerve (‘the wandering nerve’).  As a result, Dr Katinka’s treatments may successfully reduce, and even eliminate, pain and inflammation as well as enhance function and mobility in many CRPS and other pain patients.  In doing so, she has literally given back their lives!

Dr Katinka’s unique medical talents for treating chronic pain are amongst the best in the world.  Furthermore, Dr Katinka’s compassion and empathy for each of her patients adds a touch of humanity to a field of medicine that (all-too-often) appears disengaged and disconnected with the actual depth of pain and suffering endured by so many chronic pain patients.

This blog post will review 10 CRPS patients who were successfully treated by Dr Katinka.  I urge the reader to watch at least some of the YouTube links.  Like me, you will (likely) be very touched by their stories of recovery from CRPS.

It is exciting to reveal that 7 of these 10 patients achieved COMPLETE pain relief following Dr Katinka’s 10-week treatment program!  Please click on the following table to view a summary of 7 CRPS patients who now enjoy nil pain.

Table – 7 CRPS Patients Who Recovered From CRPS

The following 3 CRPS patients enjoyed significantly less pain following completion of Dr Katinka’s 10-week treatment program:

  1. Debbie (retired), whose pain levels no longer exceed 2;
  2. Kristin, whose pain levels were 2, post-treatment, compared to 7, pre-treatment; and
  3. Billi, who was finally able to extend her left leg, post-treatment.

Details of 10 CRPS Patients Successfully Treated By Dr Katinka

1. Carlos’ CRPS Story

Carlos was in a serious auto accident in 2005 that resulted in spinal cord injury and other injuries as well as constant and severe pain for 7 years.  He was formally diagnosed with CRPS 2 years later in 2007.  His CRPS started in his abdominal area and affected his entire digestive system.  His CRPS spread throughout his entire body following TENS treatment.

Carlos had to use a wheelchair and a cane due to severe pain from CRPS.  He was unable to eat solid food.  Drinking water even hurt.  His eyes had a constant burning sensation and he became sensitive to light.  Having said that, he was grateful that his vision remained unaltered.

Carlos tried everything to control his pain including pain medications, spinal injections, epidurals and a spinal stimulator implant.  Unfortunately, his severe pain levels exceeding 10 continued to torture him.

Despite Carlos having given up on hope and even on life itself, his wife convinced him to see Dr Katinka as a last resort.  When Dr Katinka met Carlos for the first time, he was unable to eat more than a couple spoons of chicken broth at a time.  The latter even caused hours of excruciating pain for Carlos.

Quoting Dr Katinka,

Carlos was white as a sheet, and utterly without hope. His pain was carved into his face for the world to see. He came in with his wife. She told me that she was afraid that Carlos would take his own life if they could not find relief soon. She had convinced him to try just one more doctor. With them that day was their nine-month old baby, Sean. I remember looking at that little boy and trying to imagine his life without his father in it to see him grow up. Carlos finally looked up and said: ‘You can’t help me. No one can help me. I am here because my wife asked me to come.’

Despite his dire state of health, Dr Katinka proceeded with her gentle upper cervical treatment on him.  To both of their surprise and for the first time in 6 years, his pain levels dropped dramatically from a 10 to a 3 following her manual procedure of his upper neck area!  Carlos finally obtained relief from his constant burning pain within the first 15 minutes of his first treatment!  What a pleasant surprise after suffering severe and constant pain due to full-body CRPS for 6 entire years!  To top this off, Carlos celebrated this milestone by finally eating a full-course dinner without pain for the first time in 5 years.

He was a changed man when he came back for his second day of treatment.  His colour had returned as did his ‘life spark’.

After his 3rd day during Week 1 and after only 3 treatment sessions with Dr Katinka, his pain levels dropped to a 2 … and then to a 1.  In fact, some parts of his body were not even sensing pain anymore!

After Week 6 at the Center, he was down to only one pain medication (from several pain medications).  Furthermore, his pain levels remained at 1 or 2.

Twelve weeks later, Carlos was completely pain-free.

Three (3) years later, Carlos stated that he was still 99% better, and that he no longer needed any pain medications.  This demonstrates the lasting benefits of Dr Katinka’s 10-week pain program.

Almost five years later in 2016, Carlos is still pain-free.  He is now working as a pastor and travels all over the world.  Whilst he has faced physical challenges since then including gallbladder surgery, he has no sign of CRPS returning.

(Carlos was interviewed 3 times by Dr Katinka – twice during his 10-week pain treatment program and a third time 3 years after his successful treatment for CRPS.)

2. Brock’s CRPS Story

Brock suffered CRPS for 10 months following a broken ankle in January 2015.  Brock was bedridden for 10 weeks due to excess pain from CRPS that also spread to his other leg.  Brock was on crutches for 7 months.  By now, his CRPS-affected leg comprised mainly of skin and bone, with only a little bit of calf and thigh remaining.  The bulk of his muscle mass in his CRPS-affected leg was gone.  Somewhere along the way, Brock also lost his job.  Needless to say, CRPS significantly changed his life for the worse in every conceivable way.

In addition to ‘tonnes of medication’, he had 4 sympathetic nerve blocks.  Unfortunately, this did not offer the pain relief that Brock needed in order to function properly.

When asked about any neck injuries by Dr Katinka, Brock confirmed that, in fact, he did have a prior neck injury prior to developing CRPS.

Brock described his first treatment during his trial week with Dr Katinka that involved gentle hands-on upper cervical manipulation as follows (quoting):

‘…completely painless, … I’ve had no side effects … no pains from the treatments  … Nothing … Amazing.’

Dr Katinka asked him, ‘So your pain level right now is?’

Brock answered, ‘I’m  a zero … zero.’  (He laughs.)

Dr Katinka enquired, ‘How does it feel?’

Brock happily replied ‘I’m smiling for the first time in a long time.  I haven’t been at a zero in almost a year now … and I’ve been amazed … 5 seconds into the first treatment … I was pain-free.’

Dr Katinka stated, ‘I’m so excited!’

Brock chuckled, ‘Me too … me too!’

3. David’s CRPS Story

David suffered CRPS in his right foot for almost 3 years following right foot surgery to remove a bunion and straighten out a ‘hammer toe’.  This was followed by a second surgery to remove a nerve from his right foot due to pain.  After these surgeries, David started having severe pain and swelling in his CRPS-affected right foot.

Post-CRPS, David walked with a cane, crutches and/or used a wheelchair due to pain.  He has his own wheelchair ramp built behind his house.  David was no longer able to drive or do anything else.  David was afraid to move for fear of making the pain worse than it already was.

As a result of the severe and unrelenting pain, David became extremely depressed.  Quoting David,

‘Depression … got so bad that, twice, I took very seriously about taking my own life … but … [my wife] … told me that there is only one that can give live and one has the authority to take life…’ 

Whilst his CRPS did not spread, his severe pain levels ranged from 11 to 13 (out of 10).

Quoting David, ‘The pain medications just numb the pain.  You have to keep it up, you’re drugged out … can’t do anything … your life is gone.’

In addition to morphine, Oxycontin and Hydromorphone, David also tried nerve blocks, without success.

On his first day at the Center, Dr Katinka asked David to lie on the treatment table for a diagnostic test.  As she chatted to David, Dr Katinka applied pressure to his neck and underneath his skull.  As she continued to apply gentle pressure in this area, his pain levels started to decrease dramatically until they reached a 2!  The pain levels did not, however, stop there.  Instead, they dropped even further as Dr Katinka continued to apply gentle pressure.  Guess what happened next??  David’s pain levels were finally at zero!  Imagine that!!  Zilch pain!!  Wow!!

After completing his trial (first) week at The Neurologic Relief Center, his right foot no longer appeared red and swollen.

Five (5) weeks later at the Center, David finally enjoyed complete pain relief and his right foot was not swollen.  David’s story of recovery from CRPS in his right foot is nothing short of amazing!

During his last 2 days at the Center, David intentionally left his walking cane in his motel room.  He was now able to walk on his own 2 feet without pain.

David’s wife, Debbie, said to Dr Katinka, ‘You have … a special heart for people in chronic pain, and it shows.’

Dr Katinka answered softly, ‘Thank you.  I do.  Especially RSD…’   

Before seeing Dr Katinka, David was in so much pain and pain-induced stress.  Now that his pain, and the stress relating thereto, was gone, David is finally looking forward to going fishing again on his own fishing boat.

David finally has his life back!  What could be better than that??

4. Madi’s CRPS Story

Madi, a teenager from Arkansas, sustained serious injuries including a fractured arm in a roll-over car accident 6 years ago when she was only 13.  Thereafter, Madi developed CRPS in her fractured arm that spread to her middle to lower part of her back as well as her entire left leg.  Her pain was sometimes so severe that she had difficulty walking.

Madi tried many different pain treatments including nerve blocks and lumbar blocks.  She has 2 stimulators surgically implanted in her back as well as a pump.  Sadly, the 2 stimulators did not reduce her pain levels at all.  While the pump offered some relief from her pain, it did not offer the amount of pain relief that she had hoped for or that she needed in order to function properly.

Madi underwent a chemical ablation (ie Phenol neurolysis) to burn her sympathethic nerve.  Sadly, this medical procedure only made her pain worse.  Madi took medication to help her sleep through the night despite the pain.

Madi felt guilty for being in pain all the time.  She felt like a burden to her family.

Understandably, Madi was sceptical about seeing Dr Katinka for the first time.  After all, no one else had been able to help her since her serious car accident 6 years ago.

However, Madi’s doubts quickly vanished after her first appointment.  When Dr Katinka performed a diagnostic test involving a gentle and non-invasive upper neck manipulation, Madi’s pain levels dropped to zero for the first time in 6 years since her car accident!  Wow!! This 100% pain relief lasted for an entire 40 minutes.

Needless to say, after her first day at the Center, Madi was eager to return for more treatments!  Even after 2 weeks (including during her YouTube interview), Madi stated that her pain levels were nil!  This is great news!

In closing, Madi’s mom said (quoting),

‘There is no amount of money that could ever give us what we have now, and it’s [Dr Katinka] that gave us that … And we talked about how her pain was locked, and how [Dr Katinka had] the key that unlocked it and made it go away…’

(Madi had just completed 2 weeks of her 10-week pain program at the Center when this interview was done.)

5. Scott’s CRPS Story

Scott suffered from CRPS for 2 years following carpal tunnel surgery to his right hand.  Scott’s pain extended from his fingertips in his right hand up his right arm and to his neck.  His pain levels in his right hand were excruciating and would always reach 8 to 10 by afternoon.  Consequently, by the end of each day, he did not want to do anything at all.

His daily pain medications included massive amounts of Gabapentin and Ibuprofen.  He also tried numerous nerve blocks as well as 5 ketamine infusions.  While the effects of the first ketamine infusions seemed promising, the actual pain relief offered by the remaining 4 ketamine infusions lasted only 2-3 weeks each.

After only 4 days of treatment with Dr Katinka, the pain from Scott’s right wrist to his neck vanished.  While there was some lingering pain in his fingers in his right hand (with pain levels at 1), this was significantly more tolerable than before.

During her gentle hands-on upper cervical manipulation, Dr Katinka confirmed that the right side of Scott’s neck had felt a bit abnormal.  Dr Katinka’s chiropractic treatment of Scott’s upper cervical area aimed to ease the pressure on his vagus nerve.  In so doing, she increased the activity of his vagus nerve.

Research by Dr Kevin Tracey shows that increased efferent vagal activity can lead to drastically reduced localised inflammation (Walker & Drummond, 2011).  This would, of course, include any inflammation in David’s CRPS-affected right hand including fingers.  Decreased inflammation often leads to less pain, and in some cases, nil pain.

And this is exactly what happened to Scott during the upper cervical procedure!

In response to her question, ‘What is your pain like?’, Scott replied,

‘Right now it’s a zero.’

Dr Katinka said, ‘Zero! That’s awesome!‘

When Scott was asked whether he had ever experienced nil pain in the past 2 years, he replied that until now, the only time he could not feel his pain was during sleep.

6. Barbara Wall’s CRPS Story

Barbara Wall worked as a registered nurse for 25 years.  In 2005, Barbara suffered a broken neck due to a severe injury to her cervical spine as well as other injuries.  She was also diagnosed with full-body CRPS.  Thereafter, Barbara was forced to quit nursing in order to focus on her health issues and constant pain resulting from CRPS, her broken neck and other injuries.

Barbara underwent daily physical, occupational and pool therapy.  In addition, she was offered various pain medications, numerous stellate ganglion blocks, lumbar sympathetic blocks and cervical epidural steroid injections, without any success.

Following a successful spinal cord stimulator (SCS) trial, Barbara received an SCS implant.  This finally offered some pain relief enabling Barbara to continue with daily physiotherapy plus 2 hours of pool therapy.

Barbara describes 10 years of full-body CRPS as ‘mind blowing, traumatic, overwhelming, and most of all changing’.

Then one day in June 2015, Barbara’s CRPS worsened when she ‘made a simple movement with [her] neck and felt a horrible pop with lightning pain … the pain was intense’.  Barbara’s SCS was no longer able to provide pain relief leading to weeks of sleepless nights.  Tests finally revealed that 2 of her discs in her neck were so badly damaged that her SCS paddle had shifted to the right, rendering it completely ineffective on the left side.  Corrective surgery was considered too risky as it could make her CRPS even worse.

Barbara’s pain levels were at 8 out of 10 when she met Dr Katinka for the first time on 12 October 2015.  These pain levels dropped to 4 after her first non-invasive, drug-free and painless treatment with Dr Katinka.

Following completion of Dr Katinka’s 10-week pain program, Barbara’s pain levels are now zero most of the time.  Barbara was also able to stop all of her pain medications.

Quoting Barbara:

‘…there is hope in hopeless situations.  Even with my continued spine issues and the need for surgery on my cervical spine, I have been able to maintain low to no pain with my RSD.  I cannot tell you how amazing it is after ten years of chronic pain to actually sleep throughout the night, to not feel like you are burning from within…’

7. Brenda’s CRPS Story

Brenda suffered from CRPS since January 2010 and her pain levels used to range between 8 to 10 ‘pretty much all the time’.

After 4 weeks of non-invasive treatment at the Center, Brenda no longer takes any pain medication.  Best of all, Brenda no longer has pain.

(No other details were provided during this short 1-minute YouTube interview.)

8. Debbie’s CRPS Story

Debbie suffered from CRPS for 12 years following a surgical procedure in March 2004.  The anesthesiologist had hit a nerve while numbing her frozen shoulder.  As a result of severe pain due to CRPS, Debbie was no longer able to work.  She also became hypersensitive to clothing including sleeves.

Debbie took many different pain medications including Lyrica and Gabapentin.  She also underwent a spinal cord stimulator operation for her pain.

Debbie received frequency specific microcurrent and other non-invasive treatments at the Center from the end of February to May 2016.

Post-treatment at the Center, Debbie feels as if she ‘has a new lease on life … a second chance’.  Debbie and her husband were finally able to go on a 3-week road trip that included many rigorous activities such as 5-mile walks.

Debbie’s pain levels are now minimal and no longer exceed 2.  Debbie added that she no longer needs Lyrica, Gabapentin nor any other pain medication.  She has not turned on her spinal cord stimulator since February 2016.

In Debbie’s words, ‘It’s just amazing!’

(This interview occurred 6 months after Debbie’s successful treatment for CRPS at the Center in 2016.)

9. Kristin’s CRPS Story

Kristin from Pennsylvania suffered from full-body CRPS for 9 years after injuring her T-spine at work.

Kristin tried many different treatments including a spinal cord stimulator trial.  However, the spinal cord stimulator had to be removed urgently due to the pain that it caused.  Sadly, during its removal, ‘they really yanked on it’.  This may have injured the lining of her spinal cord, making her pain worse.

After that, Kristin had numbness and tingling in both hands and arms, both feet and legs as well as on the left side of her face.  There was also increased burning pain and she bruised more easily.  She couldn’t work anymore due to CRPS.  Kristin could only sit and watch TV as well as sleep in the same recliner for years.  Sleeping in her bed was no longer a comfortable option.

After treatment by Kr Katinka, Kristen stated, ‘It’s basically been like a miracle.  It really has. … The first day, you were able to get rid of pain that I had in my mid back for 9 years.’

Overcome by emotion, Kristin started crying.  She continued, ‘I have so much less pain now … my RSD symptoms are still there … but cutting down on medication … I came in at a 7 and today I am leaving at a 2.’

She added, ‘It was definitely worth the 1,200 mile trip that we need, and the money, to come and see you … [Dr Katinka] is the best!’

(Kristin was interviewed on her last day at the Center after completion of Dr Katinka’s 10-week pain program.)

10. Billi’s CRPS Story

Billi is a mother and a flight attendant who can no longer work due to pain from CRPS.  Her CRPS affected her entire left arm including hand, wrist, arm and left shoulder for the past 4 years.  Billi’s pain levels averaged 3 to 4.  Different factors affected her pain levels including daily temperature and activities.  Sometimes Billi woke up without pain.  However, as soon as she got up and moved around, her pain levels spiked.

Billi tried many pain treatments including bioenergy healing, biofeedback, acupuncture and lumbar injections.

One day, Billi accidentally fell backwards while going down some stairs in Paris, France.  This resulted in a hyperstretched nerve in her left leg that prevented her from extending out her left leg while walking.

Amongst different treatments offered at the Center, Billi had frequency specific microcurrent on her left leg.  After this treatment, Billi was finally able to stretch and extend out her left leg while sitting and walking.

When asked what CRPS took away from her, Billi replied that CRPS took away her entire life including her beloved job as a flight attendant.  She added that she would love to go back to her job.  CRPS had also drastically changed her role as a mom.

Dr Katinka added, ‘Our goal is so much bigger than getting you out of pain.  It’s getting you back to your life.’

Billi started to weep softly upon hearing these kind and compassionate words.  Touched by Billi’s tears of hope and gratitude, it didn’t take long for tears to also start welling up in Dr Katinka’s eyes.

(This interview was done at the end of Billi’s first week at the Center, with more treatments planned and further progress expected for Billi.)


Dr Katinka strongly emphasizes that The Neurologic Relief Center does not aim to:

  • Numb the pain;
  • Use calmare;
  • Use ketamine; or
  • Claim to cure CRPS.

Instead, the Center aims to re-balance the central nervous system (CNS), and in particular, the autonomic nervous system including the parasympathetic nervous system (i.e. the vagus nerve).  This will allow for optimal healing from within the body.  Once the autonomic nervous system balance is restored and vagal outflow increases, reduced inflammation, significant and/or complete pain relief as well as improved function and mobility may arise.

Dr Katinka’s non-invasive treatments for neuropathic pain and injury to the spinal cord include an upper cervical procedure to stimulate the vagus nerve – see below – and frequency specific microcurrent.

Patients who respond positively to the non-invasive treatments via a dramatic decrease in their pain levels during their first week (‘trial week’) at the Centre are invited to complete the 10-week pain program.

Upper Cervical Procedure To Stimulate The Vagus Nerve

Dr Katinka believes that CRPS is like ‘a perfect storm’ that may arise in the presence of an underactive vagus nerve.  This may occur following a neck or tailbone injury that could compromise its function.  In other words, Dr Katinka believes that an injury to the CNS that could affect the vagus nerve is a major risk factor (amongst other factors) for CRPS in some patients.

Dr Katinka’s gentle hands-on upper cervical diagnostic procedure is performed on each CRPS patient during the first day of the ‘trial 1-week’.  During this diagnostic test, CRPS patients are requested to lay on the treatment table.  This non-invasive and painless procedure enables Dr Katinka to diagnose whether an underactive vagus nerve exists.

In Dr Katinka’s experience, most, if not all, CRPS patients present with a hypoactive vagus nerve.  Furthermore, in her opinion, unless the problem in the CNS (being an underactive vagus nerve) is properly addressed, many may never get to the bottom of CRPS.  In other words, if one only treats the symptoms of CRPS including pain (via pain medications, ketamine, spinal blocks, spinal cord stimulator, etc), instead of addressing the actual cause for these symptoms (such as an injury in the CNS that affects the vagus nerve), one may never be able to help CRPS patients.

Dr Katinka’s gentle manipulation of the patient’s upper cervical region often results in stimulation of the vagus nerve.  In turn, this can reduce localized inflammation almost immediately that may lead to pain relief.  These manipulations are repeated throughout the 10-week program, as necessary.

Thanks to Dr Katinka and her team, many CRPS patients are finally able to enjoy their lives without pain, while many more CRPS patients benefit from reduced pain and increased function and mobility.

Often dreams become reality at The Neurologic Relief Center, Arkansas, thanks to Dr Katinka and her team!

Sabina Walker

Blogger, Pain Matters (in WordPress)


Other Pain Matter Blog Links and References of Dr Katinka

The Wandering Nerve And CRPS

Frequency Specific Microcurrent And Other Non-Invasive Treatments For CRPS By Dr Katinka

Woohoo! Australia’s ‘One Girl’, Chantelle Baxter, Is Finally On The Road To Recovery From CRPS, Along With Other CRPS Patients, Thanks To Their Own Guardian Angel, Dr Katinka! 

Putting Out the Fire: A Brand New Approach to Treating RSD/CRPS (guest blog post, RSDSA website (12 April 2016)

Academic References on the Efferent Vagus Nerve, Inflammation, Pain, etc

Walker, Sabina, Drummond, Peter D. Implications of a Local Overproduction of Tumor Necrosis Factor-α in Complex Regional Pain Syndrome [Review Paper]. Pain Medicine (Dec 2011); 12(12): 1784–1807 (24 pages).

Patient YouTube Links and References of CRPS Patients

  1. Carlos’ CRPS Story (23 January 2015) (8 June 2011)

Putting Out the Fire: A Brand New Approach to Treating RSD/CRPS (guest blog post, RSDSA website (12 April 2016)

  1. Brock’s CRPS Story (21 December 2015)

  1. David’s CRPS Story

Groundbreaking CRPS Treatment by Dr Katinka (30 October 2015)

  1. Madi’s CRPS Story (7 August 2015)

  1. Scott’s CRPS Story (28 May 2016)

  1. Barbara Wall’s CRPS Story

My Journey Back to Health: Barbara Wall and RSD (3 May 2016)

  1. Brenda’s CRPS Story (a 1-minute YouTube)

  1. Debbie’s CRPS Story (27 October 2016)

  1. Kristin’s CRPS Story (30 May 2016)

  1. Billi’s CRPS Story (20 March 2015)



The Wandering Nerve And CRPS

Source of Featured Image of the vagus nerve (‘the wandering nerve’).

Dear Pain Matters blog readers,

As mentioned in earlier posts, Dr Katinka van der Merwe (aka Dr Katinka), a Doctor of Chiropractic at The Neurologic Relief Center, Arkansas, USA, specializes in chronic pain including CRPS.  Dr Katinka’s unique and non-invasive approach focuses on rebalancing the autonomic nervous system, with particular emphasis on the vagus nerve (‘the wandering nerve’).


Source of photo of Dr Katinka:

Dr Katinka has expertise in various non-invasive treatments including:

  • Upper Cervical Procedure (to stimulate the vagus nerve); and
  • Frequency Specific Microcurrent. 

These (and other) treatments may be beneficial for neuropathic pain and injury to the spinal cord and other painful conditions.

This blog post discusses Jennifer, a CRPS patient who suffered pain levels up to ‘10’ on a daily basis for many years until she finally attended The Neurologic Relief Center (headed by Dr Katinka).  Happily, Jennifer obtained complete pain relief following non-invasive treatments for 5 weeks at this Center.

Jennifer’s CRPS 

Jennifer’s CRPS in her right foot occurred after a stress fracture to the top of her right foot in 2007/2008.  Her CRPS spread to her right arm, wrist and hand.  Jennifer also had spinal surgery 2 years ago that involved metal implants including a metal cage, plates and screws.

Jennifer suffered shooting and excruciating pain levels up to ‘10’, 24/7, as well as severe migraines.  Her pain made it difficult to do anything including walking, working and concentrating/focusing.  Her sleep was constantly interrupted by pain and she was unable to sleep with covers due to hypersensitivity.  Jennifer had difficulty wearing shoes in the daytime.  Needless to say, a life with severe and constant pain was very  debilitating for Jennifer.

Because pain is ‘invisible’, people who had no pain could not understand her (with the exception of her supportive husband).  It was hard for Jennifer to hear people tell her, ‘There’s nothing wrong with you’, when in fact she was in such agony and pain.

Jennifer tried various pain medications including Lyrica (at maximum dosages), morphine and Cymbalta.  Jennifer said that while these drugs made her think that her pain was better, they did not enable her to do anything or function properly.  Sadly, her pain never went away no matter how high the dosages were.

Dr Katinka’s Non-Invasive Treatment For Jennifer’s CRPS 

Dr Katinka does not treat CRPS directly.  In her words (quoting from both Youtubes, below):

‘The difference between how we treat RSD [CRPS], or the neurologic symptoms of RSD [CRPS], is that we do not treat pain.  We do not numb the pain.  We do not interrupt the pain signal.  We do not attack the pain signal.  We don’t try to interrupt the nerve signal … that is not what’s causing the RSD [CRPS].  The RSD [CRPS] is caused by a malfunction in the central nervous system.

We treat the central nervous system injury.  And unless you treat that, you will never, ever permanently get the RSD [CRPS] under control, in my opinion.’

Dr Katinka added that many patients have injuries in their upper cervical region or tailbone area. These types of injuries may affect the vagus nerve.  If left untreated, these injuries can affect the central nervous system, and in particular, the parasympathetic nervous system including the vagus nerve.  Ultimately, this may trigger CRPS.

As stated above, Dr Katinka’s team offered non-invasive treatment for Jennifer’s CRPS that includes a combination of:

  1. An upper cervical procedure – This involves gentle hands-on treatment of the very upper cervical region to release, stimulate and activate the vagus nerve.  This gentle treatment removes any pressure on the vagus nerve, hence instantly restoring vagus nerve function and reducing pro-inflammatories.  When this occurs, there can be an immediate decrease in pain.  This procedure is frequently repeated during the 10-week treatment period; and
  2. Frequency Specific Microcurrent (FSM) – This is done to treat:
    • Inflammation of the spinal cord including nerves and abnormal scar tissue (from Jennifer’s spinal fusion surgery 2 years ago);
    • Allergic reactions and toxicity – Jennifer’s back surgery involved metal implants in her spine including a metal cage, plates and screws.  These metal implants are at risk of releasing toxins that may trigger metal allergies; and
    • Stenosis (ie narrowing of the spinal canal).

Jennifer shared details of her 3rd week at the Center in the YouTube dated 26 July 2015 (see below). At this time, her CRPS-affected right foot was still swollen, compared to her unaffected foot.  Furthermore, her pain levels were at ‘8’ before beginning FSM.

Jennifer confirmed that her pain vanished during FSM treatment. Instead, she had a ‘hot/warm feeling of water on the foot, with no pain. Quoting Jennifer:

‘It feels funny … It just feels funny. I’ve been having pain for so long … You have to stop and think, ‘Look, there’s nothing [ie no pain] there.”

Pleased with Jennifer’s progress thus far, Dr Katinka stated:

We don’t have tissues here, do we? I must have made you cry [with happiness] … Oh, we do [have tissues].’

Jennifer added, ‘…It’s amazing … from one day to the next … how it feels…

After FSM treatment, Jennifer practiced walking slowly down a hallway under Dr Katinka’s caring supervision. Dr Katinka stated (quoting):

…You’re done with your treatment … And you are walking on your foot. Can you normally walk on it?

Jennifer answered, ‘Not very well. No. It really hurts … Yeah, this is really different…’

When Dr Katinka asked about her pain levels while walking down the hallway, Jennifer literally sang out, ‘A ‘2’!’

After 5 weeks of treatment, Jennifer’s right foot was still swollen and slightly sensitive. The good news was that Jennifer’s pain levels were now down to ZERO (ZILCH!) for the past 2 days! Wow!  What fun!  She was also able to sleep throughout the night now, something that she had not enjoyed for years. Woohoo!

Other CRPS Patients Successfully Treated By Dr Katinka

For dozens of other CRPS success stories, please follow the links in:



Dr Katinka’s non-invasive combination treatment that focuses on rebalancing the autonomic nervous system including vagus nerve may offer pain relief and improved function for some chronic pain patients including CRPS patients.

For more on Dr Katinka’s unique insights into CRPS, please click her following guest blog post on the RSDSA website:

Putting Out the Fire: A Brand New Approach to Treating RSD/CRPS (12 April 2016)

Thanks to Dr Katinka and her team, Jennifer is finally able to enjoy her life without painful CRPS!

Sabina Walker

Blogger, Pain Matters (in WordPress)


Jennifer’s CRPS Story – 2 YouTubes by Dr Katinka van der Merwe

(1A) Jennifer’s CRPS Story (26 July 2015) (6-minute YouTube)

(1B) Jennifer’s CRPS Story (continued on 10 August 2015) (8-minute YouTube)

Frequency Specific Microcurrent for Pain 

(2A) McMakin, Carolyn. Frequency Specific Microcurrent in Pain Management (3 December 2010); Pages 1-256.

eBook ISBN: 9780702049255
Paperback ISBN: 9780443069765

(2B) McMakin, Carolyn. Nonpharmacologic Treatment of Neuropathic Pain Using Frequency Specific Microcurrent. The Pain Practitioner (2010); 20(3); 68-73.

(2C) Thomas, Brooke. Carolyn McMakin: The Resonance of Repair (A 68 Minute-Podcast Interview with Carolyn McMakin). Liberated Body (23 December 2014); LBP 030.
(2D) Treating RSD/CRPS With Frequency Specific Microcurrent (a 75-minute YouTube done 18 September 2014 by Dr Carolyn McMakin)
(2E) Other YouTubes By Dr Carolyn McMakin







Frequency Specific Microcurrent And Other Non-Invasive Treatments For CRPS By Dr Katinka

Source of Featured Image of Dr Katinka van der Merwe:

Dear Pain Matters blog readers,

As mentioned in the previous blog post, Dr Katinka van der Merwe (aka Dr Katinka) at The Neurologic Relief Center, Arkansas, USA, has expertise in various non-invasive pain treatments including Frequency Specific Microcurrent (FSM).

For more on Dr Katinka’s unique insights into CRPS, please click her following guest blog post on the RSDSA website:

Putting Out the Fire: A Brand New Approach to Treating RSD/CRPS (12 April 2016)

Frequency Specific Microcurrent is a very small current – so small that it can not even be detected by sensory nerves.  As such, it is not painful.  In fact, this current is similar to the current that is naturally produced by each cell in our body.

The FSM device (now FDA-approved) is used to treat nerve pain and injury to the spinal cord as well as many other chronic and painful conditions (see References).  Its co-founder and FSM expert, Dr Carolyn McMakin, even used this system to successfully treat her own son for CRPS.

Sunday’s Treatments For CRPS Including Frequency Specific Microcurrent (FSM) 

Sunday is a welder by trade who lives with her young daughter in Texas.  Sunday used to enjoy an active life that included basketball and softball.

Unfortunately, Sunday had a motor vehicle accident (MVA) that involved rolling her truck 6 times.  Tragically, Sunday suffered severe headaches for 3 years after this MVA.  Sunday said that her intense headaches affected 7 areas in her head including the right side, adding that they felt like a knife going in and out of her head.

Shortly after her MVA, Sunday developed severe CRPS that affected her right hand to above her right elbow.  Even a light touch on her right arm was excruciating.  Sunday also had complete numbness in all 3 middle fingers in her right hand as well as some swelling in her right forearm and hand.

Sunday stated that her severe pain never went away after her MVA, with the exception of 3 days of relief obtained during a nerve block done to the back of her head.  Her pain levels were always ‘5’ or greater, regardless of her pain treatment.  Sunday also tried epidurals (where her entire right arm was numbed), Botox injections, electroshock therapy, topical pain medications, acupuncture and many more pain treatments. Sadly, nothing helped.  Sunday stated that her severe and unrelenting pain was starting to affect her mental state.

In 2015, Sunday travelled interstate from Texas to Arkansas in the hope that she might find some pain relief at The Neurologic Relief Center, headed by Dr Katinka.  Dr Katinka’s non-invasive treatments were different from Sunday’s other pain treatments to date.  This is because Dr Katinka focused on treating the original injury caused by her car accident.  In Dr Katinka’s view, Sunday likely sustained an injury to her upper cervical region during her motor vehicle accident that may also have led to CRPS in her right arm.

Following treatment of her injured upper cervical spine on her first day, Sunday’s pain levels dropped to a ‘4’. After her 2nd day of treatment, Sunday’s pain dropped further to a ‘3’.  On her 3rd day of treatment, Sunday’s pain was a ‘4’ prior to undergoing FSM.

Guess what happened next??

During her 1st FSM treatment on her 3rd day, Sunday started to feel some tingling in her 3 fingers!  Wow!!  (Until now, Sunday had endured 3 years of numbness in these 3 middle fingers, post-MVA.)  Sunday’s pain levels also dropped to a ‘3’ after FSM.  Finally, there was no more pain above Sunday’s wrist and her pain was now limited to the base of her wrist following her successful FSM therapy.

In Sunday’s words,

‘It does not hurt [above the wrist] … It’s awesome … It’s awkward … It’s weird … Just my joints are sore, but everything else is not [sore] …’

Thus, Sunday felt more than 50% better within only 1 week of treatment at The Neurologic Relief Center!  Sunday’s pain due to CRPS was now limited to her right wrist only and a tingling sensation had finally returned to her 3 fingers for the first time after 3 years of numbness following her MVA.  The swelling in her right arm was also reduced.

Sunday’s first week at The Neurologic Relief Center offered hope that a life with less pain and greater right hand function was now possible!  Sunday was excited about completing the full 10-week treatment program at this Center shortly.

Other CRPS Patients Successfully Treated By Dr Katinka

For dozens of other CRPS success stories, please follow the links in:



Frequency Specific Microcurrent may offer pain relief and improved function for some chronic pain patients including CRPS patients.  As such, FSM warrants further investigation (see References for papers by FSM expert, Dr Carolyn McMakin).


It is heart-warming to see that some CRPS patients such as Sunday are finally getting their lives back thanks to passionate and compassionate Pain Doctors including Dr Katinka!

Sabina Walker

Blogger, Pain Matters (in WordPress)


Sunday’s CRPS Story – 3 YouTubes by Dr Katinka van der Merwe

(1A) Sunday’s 1st Day of Treatment for CRPS (16 March 2015)

(1B) Sunday’s 3rd Day of Treatment for CRPS (18 March 2015)

NB This YouTube includes a discussion of Frequency Specific Microcurrent (FSM).

(1C) Sunday’s 5th Day of Treatment for CRPS (20 March 2015)

Frequency Specific Microcurrent (FSM) for Pain 

(2A) McMakin, Carolyn. Frequency Specific Microcurrent in Pain Management (3 December 2010); Pages 1-256.

eBook ISBN: 9780702049255
Paperback ISBN: 9780443069765

(2B) McMakin, Carolyn. Nonpharmacologic Treatment of Neuropathic Pain Using Frequency Specific Microcurrent. The Pain Practitioner (2010); 20(3); 68-73.

(2C) Thomas, Brooke. Carolyn McMakin: The Resonance of Repair (A 68 Minute-Podcast Interview with Carolyn McMakin). Liberated Body (23 December 2014); LBP 030.

(2D) Treating RSD / CRPS With Frequency Specific Microcurrent (a 75-minute YouTube done 18 September 2014 by Dr Carolyn McMakin)

(2E) Other YouTubes By Dr Carolyn McMakin



Woohoo! Australia’s ‘One Girl’, Chantelle Baxter, Is Finally On The Road To Recovery From CRPS, Along With Other CRPS Patients, Thanks To Their Own Guardian Angel, Dr Katinka!

Source of Featured Image of Chantelle Baxter:

Dear Pain Matters readers,

You may remember reading about Chantelle Baxter, co-founder of ‘One Girl’, in a previous blog post:

The great news is that Chantelle has finally started to recover from CRPS following a 15-week treatment program recently completed at The Neurologic Relief Center, Arkansas, USA (headed by Dr. Katinka van der Merwe; links below).

While she looks forward to a FULL recovery from CRPS, Chantelle’s progress so far is nothing short of amazing!  None of this would have been possible without her own Guardian Angel, Dr Katinka van der Merwe!  I am very happy for Chantelle!!

Chantelle’s Own Guardian Angel, Dr Katinka van der Merwe

Growing up in South Africa in a chiropractic family and earning a Doctor of Chiropractic degree at the Parker College of Chiropractic, South Africa, in 1999, Dr van der Merwe DC QNP specializes in the treatment of chronic pain.  Her non-invasive approach focuses on rebalancing the autonomic nervous system, with particular emphasis on the vagus nerve.  Dr van der Merwe and her dedicated team have expertise in many non-invasive treatments including:

  • Restoring tone to the vagus nerve (via gentle, hands-on upper cervical procedure by Dr Katinka);
  • Frequency Specific Microcurrent (for reducing inflammation in the nerves as well as detoxification – see Sunday’s and Jennifer’s CRPS stories);
  • Neuromuscular re-education – This helps the nervous system to ‘reconnect’ with skeletal muscles to restore proper mobility and break poor movement habits;
  • Neurological/nerve rehabilitation;
  • Bioenergetics synchronization technique;
  • Functional medicine and neurology;
  • Neurologic Relief Centers Technique (NRCT);
  • Biologic medicine;
  • Quantum Neurology; and
  • Nutrition/personalized supplementation (based on genetic profiling).

These treatments are constantly reviewed and updated in order to improve success overall rates.

Two treatments are done within the first week to ensure the patient responds before admitting patients into the lengthy 10-week program.

Alexis’ Own Guardian Angel, Dr Katinka van der Merwe

Chantelle is not the only ‘Happy Camper’ after being cared for by Dr Katinka at The Neurologic Relief Center.

Alexis (18) has full-body CRPS that started in her left knee about a year ago.  Alexis received regular Ketamine treatment (1,200 mg) for her painful CRPS that persisted 24/7.  Ketamine helped bring her pain rating down from +’ to ‘4’, albeit with many of the adverse effects of Ketamine.

Recently, Alexis also received treatment from Dr Katinka and her team.  With treatments including Ketamine and ‘Neuromuscular Re-Education’ (the latter done by Dr Katinka), Alexis’ pain rating dropped to ‘0’ for a week (thereafter, ‘2’).

Shortly before this interview was done, Alexis’ pain rating was ‘0’ (NIL.  ZILCH! NADA!!)!  And this occurred after only 4 ‘Neuromuscular Re-Education’ treatments!

For more details, please see this YouTube dated 4 June 2017 called ‘AlexisCRPS 1 1’:

Dr Katinka, all I can say is ‘Wow!  Congratulations for doing such a great job!!’

Some Other Amazing CRPS Patients Successfully Treated By Dr Katinka van der Merwe At The Neurologic Relief Center

(1) Barbara Wall’s CRPS Story –

(2) Jennifer’s CRPS Story –

Part 2/2 –

Part 1/2 of Jennifer’s Story is in References.  NB Both YouTubes on Jennifer include some treatment details.

(3A) Sunday’s CRPS Story –

(NB This YouTube includes a discussion of Frequency Specific Microcurrent.)

(4) David’s CRPS Story –

NB This YouTube includes the patient’s description of Dr Katinka’s gentle hands-on treatment around the upper neck/below head region to activate his vagus nerve.  This targeted and non-invasive treatment to re-balance his autonomic nervous system during the first week of treatment led to rapid and COMPLETE pain relief for David.

(5) Debbie’s CRPS Story –

(6) Kristin’s CRPS Story –

(7) Madi’s CRPS Story –

(8) Scott’s CRPS Story –

(9) Brock’s CRPS Story –

(10) Billi’s CRPS Story –

(11) Carlos’ CRPS Story –

Also, please see, and

(12) Brenda’s CRPS Story –

(13) For many other CRPS success stories, please view:


For Dr van der Merwe’s unique insights into CRPS, please click her following guest blog posts on the RSDSA website, particularly the first one:

(1A) Putting Out the Fire: A Brand New Approach to Treating RSD/CRPS (12 April 2016)

(1B) The Myth of a Cure for CRPS (11 October 2016)

(2) The following is a fantastic YouTube called ‘What Do We Do?’ that explains Dr Katinka’s non-invasive treatments for CRPS (and fibromyalgia):

(3) To help CRPS patients further, Dr. Katinka van der Merwe also wrote a book called ‘Putting Out The Fire – New Hope For RSD/CRPS’ (available in Amazon; links below).

I am soooo happy for Chantelle, Alexis and all the other CRPS patients successfully treated by Dr Katinka van der Merwe!  The list of Dr Katinka’s very happy CRPS patients just keeps growing and growing!!

Dr Katinka has literally given the lives back to the aforementioned, and many other, CRPS patients! 

Sabina Walker, Blogger

Pain Matters (in WordPress)


(1A) Dr. Katinka van der Merwe. Putting Out The Fire – New Hope For RSD/CRPS (24 October 2016); 288 pages.

ISBN-10: 1534832645
ISBN-13: 978-1534832640

(1B) Dr van der Merwe.  Putting Out The Fire (a 4-minute YouTube)

(1C) Dr Katinka’s website

(2) The Neurologic Relief Center, Arkansas, USA (headed by Dr. Katinka van der Merwe)

Neurologic Relief Centers Technique (NRCT)

(3) Additional YouTubes of CRPS Patients Successfully Treated By Dr Katinka van der Merwe At The Neurologic Relief Center

(3A) Jennifer’s CRPS Story (Part 1/2;  Part 2/2 is incorporated in this Blog Post, above.)



CRPS Is Not ‘Rare’ In Fracture Patients

An important update on 29 April 2017 (regarding good news about Chantelle Baxter):

Great news!!  Chantelle Baxter is finally on the road to recovery from CRPS!

I am so thrilled and happy for her!  We need many more stories like this!


Dear Pain Matters readers,

Complex regional pain syndrome (CRPS) is often said to be ‘very rare’.

However, one does not have to look far to read or hear about someone with this medical condition.

My previous blog posts introduced 2 young and courageous women:

  • A Canadian named Paula Orecklin (29) from Winnipeg (nicknamed ‘Winterpeg’, for obvious reasons) (see bottom for links); and
  • An Australian named Chantelle Baxter (32), from ‘The Land Down Under’, Melbourne, Australia (see bottom for link).

While Paula and Chantelle grew up in 2 very different parts of the world, 15,000 km away from each other, both women share at least one thing in common.

On behalf of all Canadians living with chronic pain, Paula Orecklin was formally selected to be an Olympic torchbearer for the 2010 Vancouver Olympic Winter Games.  What an honour this is!

Meanwhile, Chantelle Baxter set a goal to educate one million (1,000,000!) girls in Africa by 2020!

Not only are both women truly amazing and inspirational, but sadly, both women also share a very painful medical condition called complex regional pain syndrome (CRPS).

How many others are there in this world just like Paula and Chantelle who are battling CRPS at this very moment??

Statistics of CRPS in Fracture Patients

The following 4 medical papers offer some insight into the incidence of CRPS in fracture patients.  Specifically, these studies state that CRPS may arise in (anywhere from) 7% to 48.5% (ie almost half!) of all fracture patients following fracture and treatment.

(1) A Korean study showed that 42 of 477 (ie 8.8%) of all surgically-treated wrist fracture patients developed CRPS1. Specifically, females with a high energy wrist trauma or a severe comminuted fracture had the highest risk of developing CRPS1 after surgery (Roh et al, 2014).

(2) A Dutch study reported similar results, whereby 7% (42 of 596) of all fracture patients developed CRPS1 following ER treatment (using the Harden and Bruehl diagnostic criteria). Alternatively, if the IASP diagnostic criteria for CRPS1 are applied, 48.5% (ie 289 of the same 596 fracture patients) had CRPS1 after treatment. Meanwhile, if the Veldman criteria were used, 21.3% of the same fracture patients (ie 127 of 596) developed CRPS1 after treatment. Thus, depending on the diagnostic criteria used for CRPS1, between 7% to almost half (!) of all 596 fracture patients developed painful CRPS1 following treatment.

Furthermore, all patients who developed CRPS1 after fracture and treatment still had ongoing severe pain and other CRPS1 symptoms that persisted even at 1-year follow-up. The Dutch researchers added that those who sustained an ankle fracture, dislocation or intra-articular fracture were at highest risk of developing painful CRPS1 (Beerthuizen et al, 2012).

(3) A Tunesian study reported that CRPS1 occurred in 32.2% (29 of 90) of all distal radius fracture patients following treatment involving closed reduction and casting. In other words, CRPS1 occurred in almost 1 in 3 distal radius fracture patients during the 3rd and 4th week after cast removal! Those at highest risk were females who reported severe pain and impairment of physical quality of life following comminuted, operated and casted wrist fractures (Jellad et al, 2014).

(4) An Italian study reported that CRPS occurred in anywhere from 1% to 37% of all fractures following orthopedic surgery, depending on the severity of the fracture. Patients at highest risk were women, older people, smokers and those with reduced bone strength. Early diagnosis is linked with remission in up to 90% of all cases. Where diagnosis of CRPS was delayed, electroanalgesia (e.g. spinal cord stimulation) sometimes offered promising results (Corradini et al, 2015).

I don’t know about you … but if the number of fracture patients who develop CRPS varies anywhere from 7% to almost half (!) of all fracture patients (depending on the criteria used to diagnose CRPS), this certainly does not sound like a ‘rare’ condition.


The good news is that if diagnosed and treated early, recovery from CRPS is likely.  Having said this, part or full recovery from CRPS is still possible in some cases even if diagnosed later (see large, 6-page Table in our review paper; Walker and Drummond, 2011).

Here’s to hoping that these statistics hit home with a strong message that CRPS is not rare, especially in fracture patients.  Complex regional pain syndrome does not discriminate based on age, gender, culture, race, skin colour, religion or any other criteria.

Clearly, the goals should be:

  • Early diagnosis of CRPS.  If unsure, pain and other medical specialists may be helpful with diagnosis;
  • Prompt referral to pain and other medical specialists;
  • Timely and effective treatment for CRPS; and
  • Regular follow-up until pain and other symptoms of CRPS are properly managed and/or reversed altogether.

Continuing research into CRPS is warranted.

After all, there may be a lot more ‘Paula’s’ and ‘Chantelle’s’ in this world battling CRPS than originally thought!

Sabina Walker, Pain Matters blogger


Incidence of CRPS following Fracture

(1) Roh YH, Lee BK, Noh JH et al. Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture. Arch Orthop Trauma Surg (Dec 2014); 134(12): 1775-1781.

doi: 10.1007/s00402-014-2094-5

(2) Beerthuizen A, Stronks DL, Van’t Spijker A, Yaksh A, Hanraets BM, Klein J, Huygen FJ. Demographic and medical parameters in the development of complex regional pain syndrome type 1 (CRPS1): prospective study on 596 patients with a fracture. Pain (June 2012); 153(6): 1187–1192.


(3) Jellad A, Salah S, Ben Salah Frih Z. Complex regional pain syndrome type I: incidence and risk factors in patients with fracture of the distal radius. Arch Phys Med Rehabil (March 2014); 95(3): 487-492.

doi: 10.1016/j.apmr.2013.09.012.

(4) Corradini C, Bosizio C, Moretti A. Algodystrophy (CRPS) in minor orthopedic surgery. Clinical Cases in Mineral and Bone Metabolism (2015); 12(Suppl 1): 21-25.

doi: 10.11138/ccmbm/2015.12.3s.021.

Examples of Patients who have Partly or Fully Recovered from CRPS following Anti-Inflammatory Treatment

(5) Walker, Sabina, Drummond, Peter D. Implications of a Local Overproduction of Tumor Necrosis Factor-α in Complex Regional Pain Syndrome [Review Paper]. Pain Medicine (Dec 2011); 12(12): 1784–1807 (24 pages).

(See large, 6-page table on pages 1791 – 1796.)

CRPS Patients Discussed in this Pain Matters Blog

(6) Paula Orecklin

(7) Chantelle Baxter

(8) Four (4) CRPS Patients Including Paula Orecklin

‘One Girl’ From Australia Named Chantelle Baxter Is Determined Not To Let CRPS Win!

Source of Featured Image:

Go Fund Me – Help Chantelle heal from CRPS

Dear Pain Matters blog readers,

Today I would like to write about a very brave and inspirational young woman named Chantelle Baxter, a 32-year old entrepreneur from Melbourne, Australia, who sadly developed complex regional pain syndrome (CRPS) last year after twisting her left ankle during a hike in Portland, Oregon.

Chantelle is undergoing a 10-week pain treatment program at The Neurologic Relief Center, Arkansas, USA (headed by Dr. Katinka van der Merwe).  Because of its expenses, Chantelle is grateful for any donations (via ‘Go Fund Me’) that may help finance her pain treatments:


Chantelle Baxter (above 2 photos, before CRPS, including a photo with her partner)
Source of image:  The Age (17 April 2017).

CRPS is Not ‘Rare’ in Fracture Patients 

Complex regional pain syndrome is often said to be ‘very rare’.

However, the next blog post highlights 4 medical papers that suggest otherwise.  Specifically, these studies state that CRPS may arise in anywhere from 7% to 48.5% (ie almost half!) of all fracture patients following fracture and treatment.

I don’t know about you … but if the number of fracture patients who develop CRPS varies anywhere from 7% to almost half (!) of all fracture patients, this certainly does not sound like a ‘rare’ condition!   

See next blog post for statistical details about CRPS in fracture patients.

Who is Chantelle Baxter?

Several years ago, Chantelle set a goal to educate one million (1,000,000!) girls in Africa by 2020.  To help achieve this altruistic goal, Chantelle co-founded ‘One Girl’, one of Australia’s fastest growing non-profit organizations.  So far, One Girl has already reached out to thousands of girls and women in Sierra Leone and Uganda.

Chantelle was recently selected as one of the ’30 Influential Aussie Women Under 30′ as well as ‘Melbourne’s Top 100 Most Influential People’ by Melbourne’s paper, The Age.

Wow!  This is One Girl with One Big Heart!!

Chantelle’s Current Challenge:  CRPS Caused by a Twisted Left Ankle During a Hike 

Chantelle has painful CRPS caused by a twisted left ankle that occurred during a hike last year in Portland, Oregon.  While Chantelle did not fracture her left ankle, her entire left foot started to burn with severe pain and it became ‘incredibly swollen’ with ‘a purple, red colour’.

Chantelle flew back to Australia from Portland, Oregon, the very next day after her hike.  Sadly, by the time she landed, she could hardly put any weight on her left foot.  Quoting Chantelle:

‘By that stage my foot was a strange purple, red colour and incredibly swollen … I knew something was very wrong — so I spent the next six weeks getting every test under the sun — MRI, ultrasound, bone scan, CT scan, blood work — I visited specialist after specialist and none of them could give me an answer about what was going on …’

Chantelle continued:

‘… and eventually I gave up trying to find an answer and flew back to the US, where a doctor finally diagnosed me with CRPS [in January 2017].’

Chantelle describes CRPS as (quoting):

“someone is melting the bones inside my legs. Like I’m being burnt alive from head to toe. Or that my entire body was being dipped in acid.”

Despite nicknaming CRPS ‘The Suicide Disease’ (due to the extreme pain levels that she endured), Chantelle is not known as One Girl who gives up easily in the face of adversity and challenge.

As stated earlier, Chantelle is undergoing a 10-week treatment program at The Neurologic Relief Center, Arkansas, USA (headed by Dr. Katinka van der Merwe).

Chantelle’s treatments for CRPS include:

  • ARP Wave therapy;
  • Frequency Specific Microcurrent; and
  • Daily chiropractic adjustments to release the pressure on her vagus nerve (see References on Dr. Kevin Tracey’s extensive research on the importance of the efferent vagus nerve including its role in inflammation and pain).


Source of image:  Cunningham, Melissa. The Age (17 April 2017).
(There is also a 2-minute video in this link.)


Source of image:


Here’s hoping for this One Girl’s speedy recovery from CRPS!

Sabina Walker

Pain Matters blogger

An Important Update

Please see my update on 29 April 2017 on Chantelle Baxter, who is finally starting to recover from CRPS!:


About Chantelle Baxter and One Girl

(1) Cunningham, Melissa. ‘Someone was melting the bones inside my legs’: Chantelle Baxter’s CRPS battle. The Age (17 April 2017).

(2) Mayoh, Lisa. Chantelle Baxter is battling the most painful condition on Earth. News (19 April 2017).

(3) Markwell, Lauren. Go Fund Me – Help Chantelle heal from CRPS (26 March 2017).

(4) One Girl

Dr. Kevin Tracey’s Research on the Efferent Vagus Nerve and its Role in Inflammation and Pain

(5) Behar, Michael. Can the Nervous System Be Hacked? The New York Times (Magazine) (23 May 2014).

(6) Vince, Gaia. Hacking The Nervous System. Mosaic Science (26 May 2015).

(7) Fox, Douglas. The Shock Tactics Set to Shake Up Immunology. Nature (04 May 2017); 545: 20–22.

doi: 10.1038/545020a!/menu/main/topColumns/topLeftColumn/pdf/545020a.pdf

(8) Koopman FA, Chavan SS, Miljko S, Grazio S, Sokolovic S, Schuurman PR, Mehta AD, Levine YA, Faltys M, Zitnik R, Tracey KJ, Tak PP. Vagus Nerve Stimulation Inhibits Cytokine Production And Attenuates Disease Severity In Rheumatoid Arthritis. PNAS (2016); 113(29): 8284-8289.

doi: 10.1073/pnas.1605635113

This is the story of my exploration on matters of chronic pain.