I am a physical therapist with 26 years of experience who works with adults with chronic pain and was shocked and dismayed when my active 11 year old daughter, who had multiple sprains and strains in the past, showed signs of complex regional pain syndrome (CRPS) also called RSD in her left foot after a minor injury.
CRPS/RSD is a neuro inflammatory condition and it affects the autonomic nervous system – think flight or fight and all of the things that occur in the body we do not consciously control. The brain and nerves get their signals crossed and send constant pain signals to the brain in a non-stop and escalating loop (with the pain comes a fear of movement which causes anxiety, which amps up the flight or fight system even more) and it results in various physical changes increased
temperature, swelling, discoloration, and decreased strength. Unfortunately, scientists do not know why some people get CRPS and others do not although recent research is showing a link between autoimmunity. 1, 2. My 17 year old son and I, as well as a plethora of cousins, have autoimmune diseases. Other studies have demonstrated differences in the somatosensory areas of the brain (Rachael has some minor sensory integration issues), or differences in the cells of the central nervous system, or a genetic component.3, 4.
Essentially we may never know the cause, but we found what helped my daughter to break the cycle.
After my initial mom panic mode on seeing Rachael’s foot and leg turning purple and realizing that it was CRPS, I went to work. Her initial doctor wanted her to have nerve blocks; I had done enough research to know we were not going to start that way. Her second doctor was wonderful but thought the biofeedback and therapy could come later if the P.T. did not work. Having been part of a comprehensive pain management program with Baylor, I believe biofeedback and cognitive therapy is a significant part of the rehabilitation process with chronic pain, and I found Rusty and the Center for Biofeedback and Behavior Therapy.
By this time Rachael had been on crutches or in a wheelchair for almost two months and was unable to tolerate the lightest touch to her foot. The left lower leg was swollen and the skin on her foot was peeling; she had lost all active movement of her foot and was losing muscle mass. Rachael was also unable to sleep, had difficulty concentrating at school due to the 24 hour a day, unrelenting burning pain. Worst of all my happy, joyful girl was so, so sad. She kept a smile on her face all day long; she said it did not take away the pain, but it made her feel better.
I called Rusty, explained our situation and he told us to come in for an evaluation. He taught her some basic biofeedback techniques (which she practiced and showed all of her friends), showed her his awesome gym and we started treatment the next week. Rachael was so excited to be doing something physical after being sidelined that she was able to work through her pain and essentially reset the system so by the end of her very first session, she was able to take some steps for the first time in almost two months. I will always remember her looking at me with big tears in her eyes “mom, I am so happy”. I believe that was the first time she had hope that she would be able to walk again. She put her crutches down the next day and took her first steps and was able to weight bear and walk on a treadmill at physical therapy.
Rachael has been in remission since December. She has hypermobile joints and has had some injuries since that time and will likely have more (she is a VERY active child!) but now she automatically uses many of the techniques that Rusty taught her to keep her from a flare and a relapse, which is always a concern. She also uses the techniques for any stressful situation, so she has learned lifetime skills that she can use to overcome any obstacle she may encounter along the way.
1. Dirckx M, Schreurs MWJ, de Mos M, Stronks DL, Huygen FJPM. The Prevalence of Autoantibodies in Complex Regional Pain Syndrome Type
I.Mediators of Inflammation. 2015;2015:718201. doi:10.1155/2015/718201.
2. Goebel ABlaes F. Complex regional pain syndrome, prototype of a novel kind of autoimmune disease. Autoimmunity Reviews. 2013;12(6):682-686.
3. Borchers AGershwin M. Complex regional pain syndrome: A comprehensive and critical review.Autoimmunity Reviews. 2014;13(3):242-265.
4. Barad M, Ueno T, Younger J, Chatterjee N, Mackey S. Complex Regional Pain Syndrome Is Associated With Structural Abnormalities in Pain-Related
Regions of the Human Brain. The Journal of Pain. 2014;15(2):197-203. doi:10.1016/j.jpain.2013.10.011.
5. Maihöfner C, Seifert F, Markovic K. Complex regional pain syndromes: new pathophysiological concepts and therapies. European Journal of Neurology.
My 11 year old son had been struggling with chronic abdominal pain for several months. My active, athletic boy was forced to lay on the couch hunched over in pain every day. We were frustrated and exhausted. We were referred to Rusty Lozano by our pain management team at Children’s and were told that he gets “amazing results”.
I immediately came home and did some research. The testimonials on his site were amazing! I entered a quick message on his website and within an hour Rusty called me personally and we discussed my son’s condition and symptoms and he told me he could help him.
We set up the initial consultation and that day my son came into the Biofeedback clinic with a pain level of 5 out of 10. After the evaluation, Rusty suggested that we try some techniques to see if we could relieve my son’s pain. Within MINUTES of working with Rusty, my son’s pain was nearly gone!
We literally had not had a day without pain in months! I admit I was skeptical and couldn’t wait for him to get to the car to tell me how he was really feeling. But, before we left the office, he described to Rusty that it was like something he had read in a book and that the pain had been taken away!
My son woke up the next day with a small amount of pain. He told us that he used the techniques that he learned and it went away. He has continued to be pain free for weeks now! Not once has he mentioned pain at all!
My son just started middle school and remains PAIN FREE! We are so thankful we stumbled upon Rusty and his biofeedback clinic. It has literally changed our lives!
The MAYO CLINIC recommended us to Rusty from New York! Kevin had abdominal pain and sleep issues that would keep him up constantly at night. It was common for me to be woken up 3-4 times throughout the night to scratch Kevin’s back to help him fall asleep. His pain was constant for 15 solid months.
After going to every specialist imaginable we were directed to the MAYO Clinic.
Kevin underwent several specialized exams that really gave us little answers as to why this was happening. The psychiatrist there referred us to Texas to see Rusty.
We flew down to Dallas for a week and It was a miracle!!! Kevin’s abdominal pain went away on our third visit. That night, he also slept through the night at the hotel. I was in utter disbelief and fell on my knees and cried so profusely.
Kevin was pain free the remainder of the treatments and the rest of the week AND up until this very day. Omg I’m crying as I write this. Rusty I am so glad we found you. Thank you.
New York, NY
Words can express what I’m feeling right now as a desperate mom who has been to countless doctors to try find relief for my 11 year old son, Everette. When we met Mr. Lozano, he had a gentle demeanor and I could tell he was very invested in us. what I can describe as nothing short of a MIRACLE, Everette was able to relieve his headache within for the first 15 minutes of our visit. This is the first time we have experienced relief in the 8 months we have been seeking help. Fast forward.. We are graduated now and Everett has been symptom free for nearly 1 month. We still stay on his retainer medication prescribed by his doctor but we are on a completely new path. Thank you Rusty.. Bless the man you are and helper God put you on this earth to be. Sincerely.
Rusty is INCREDIBLE! My Son is suffering from eye and facial spasms and after having been with Rusty less than a week, he is feeling there is a light at the end of the tunnel. Rusty has a wonderful way about him and truly cares and wants to help. After over a year, we were truly blessed with an answer to our prayers to find someone to help him when recently we found Rusty Lozano! Do yourself and anyone you love and care about a favor. Don’t wait a second, call Rusty. It will be the one of the most valuable phone calls you will ever make!
I want to thank you so much for all that you were able to accomplish with my daughter Riley last week. As you know, Riley suffered a concussion 7-31-11 from heading a soccer ball. From that day on, she was never without a headache. On a scale of 1-10, her headache was normally a 7. Due to the headache, she has not been able to attend school at all this year.
From August 2011 through April 2012 she was treated as an outpatient by 7 different physicians, and tried 6 different medications. In February 2012 she was admitted to a local children’s hospital for intractable headache. While hospitalized, she was treated by the pediatric team, neurology team, opthalmology, behavioral health, and had a lumbar puncture. They tried several different meds, all without any success. She was discharged with her headache and told her only option was to try another medication, but we wouldn’t know for weeks if it was going to help. As before, the medication only made her worse. At her followup appointment she was weaned off of her medication and given no other options.
2 months later, Riley had an appointment with a well known neuropsychologist who specializes in concussions. His answer, “Go back to school and exercise”.
I have worked in the medical field for 18 years as a Physician Assistant, and even with my background, I felt like Riley was in a pinball machine getting bounced from one doctor to the next. None of the physicians helped her, and none of them agreed on treatment. They diagnosed her with post-concussion syndrome, chronic migraine and persistent daily headache.
In early March, I began to search for someone to treat Riley with biofeedback. There was no one in our area who could provide this service. Through my research I came across your website and read every section. I was very impressed by your testimonials and success with headaches. I was concerned whether you would be able to help Riley considering we are from Ohio. When I contacted you, you were confident that you could , and gave me enough hope that we made the trip to Addison in April. I came full of hope, Riley came skeptical because no one had been able to give her any relief in the prior 8-9 months.
When we landed in Dallas, not only was she dealing with her headache, but she was now dealing with significant anxiety about returning to school. You met us on Saturday within 2 hours of landing. After doing her initial biofeedback evaluation, you were able to relieve her headache within 10 minutes-!! Unbelievable, but she confirmed it. Of course the headache returned, but you were able to teach her techniques to follow on a daily basis to keep them under control.
As the week went on, you continued to work with the headaches and also focus on her school related anxiety. When she had her last session on Friday, I have to admit that I was a little scared, but you took me into your office first and gave me the tools that I needed to get her back to school. Then, you talked to Riley and assured her that if she wasn’t able to get rid of a headache on her own that you were always available by phone.
As I began to write this letter, Riley was getting ready to go back to school in the morning. The fact that this was occurring after only one week with you was truly a miracle. As I finish this letter, she has completed an entire week of school. Her anxiety is down, and I know when the next school year starts it will be much easier for her.
Rusty, I can’t thank you enough for all that you have done for us. I am so lucky to have found your website. Coming to Addison was definitely a risk worth taking. The people of Dallas are lucky to have you so close, and the rest of us are lucky that you are willing to be only a phone call away.
January 16, 2010
Steven Linder, M.D.
Medical City Dallas, Suite A307
7777 Forest Lane
Dallas, Texas 75230-2507
Dear Dr. Linder,
Our 14-year-old daughter Sophie sustained a concussion on October 5, 2009, and suffered an intensely painful post-concussive headache for 5 weeks. She was out of school for two weeks, and at school for half-days for three weeks, as a result of the headache. The headache pain was localized in a specific area of the brain, near her right temple. The headache pain did not move around her head. Sophie tried several pain-relief type medicines (Tylenol, Advil, Extra-strength Excedrin, ____________ and ______________ as prescribed by you originally for Sophie’s migraine headaches) for her headache, but nothing worked. Finally, out of desperation, I contacted Rusty Lozano at the Center for Biofeedback & Behavior Therapy, whose card you gave me September 8, 2009.
On Sophie’s 35th straight day of suffering from the post-concussive headache, Monday, November 9, 2009, Sophie met with Mr. Lozano. Within the 50 minute appointment time, Rusty helped Sophie stop her headache pain without the use of any drugs.
Sophie was pain-free for 24hrs, until a headache returned again at the end of Sophie’s shortened school day. Interestingly, this headache was presenting different pain than the post-concussive headache pain Sophie suffered for 35 days. This headache pain was like the migraine headache pain that Sophie has experienced in the past, where the pain moves around her entire head. We called Mr. Lozano as soon as Sophie was home from school, and over the phone, Mr. Lozano “talked” Sophie through a series of “steps” which relieved Sophie from headache pain again. The process took about 7-9 minutes.
Sophie was pain-free again, but only for a couple of hours, when the migraine-styled headache returned. We called Mr. Lozano again, who again talked Sophie through some steps that helped Sophie again stop her headache pain a second time. This was the final headache. Sophie has not had a migraine headache since November 10, 2009.
Sophie has been seeing Mr. Lozano for five appointments at this point. She has not suffered any headaches since Mr. Lozano “talked” her through her last one on November 10th. Interestingly, however, while vacationing during Thanksgiving with extended family, Sophie started to feel the beginning of a migraine. She immediately started going through the steps that Mr. Lozano had taught her, and the beginning pain of a migraine went away. Sophie said the whole process took about 10-15 minutes.
As a mom, I’m really excited about what Sophie has learned from Mr. Lozano. She can stop headache pain from escalating into a migraine and completely eliminate headache pain, all without the use of any drugs. Thank you for referring me to Mr. Lozano.
Hi Dr. Lozano-
I just wanted to thank you for all of your help, and to express my continued amazement and thankfulness at and for the helpfulness of your biofeedback therapy techniques, in regards to Savannah’s chronic daily tension headaches over the past 8-10 weeks. It was the thing which was first effective in alleviating the headache pain, and in giving her a sense of control over her health and daily routine.
Savannah began having headaches during the last week of February, and they lasted all day, every day, and were unrelieved by any OTC remedies. Her pediatrician diagnosed her with tension headache, and ultimately referred us to a pediatric neurologist. Before we were able to make an appointment with the neurologist, we ended up checking Savannah into Dallas City Children’s Hospital, due to the severity of the headache. She was treated with IV medications and released improved after 24 hours. Dr. Moein saw Savannah during her stay, and she performed a physical exam and confirmed the pediatrician’s diagnosis of chronic tension type migraine. Dr. Moein prescribed a blood pressure medication (Nadolol) on 3/4 and told us that it could take several weeks to reach full efficacy. Within 24 hours of Savannah’s release from the hospital on 3/4, the headache was back at full strength. As the weeks went on, we went through every possible test (CT scans, MRI/MRV/MRA scans, blood tests- all, thankfully, normal) trying to find a physical cause for these ever-worsening headaches. We also tried acupuncture, and massage. Neither provided any lasting relief.
Savannah has also been seeing a clinical psychologist, in order that she may learn some coping mechanisms for handling daily stressors (academic, social, etc.), and that therapy has been very helpful, though the headaches continued. After several more weeks during which the pain was unrelieved, and the discomfort was worsened by Savannah’s inability to sleep, on 3/21 Dr. Moein added a daily course of amitriptyline as an adjunct to the Nadolol originally prescribed as a preventative. This had no immediate effect on the severity of the headaches, though thankfully it did help her to sleep at night. Several weeks later on 3/25, we tried a four day hospital admission for IV administration of 16 courses of dihydroergotamine, often used for treatment of intractable migraine. She was much improved at the end of four days, and we were encouraged, but again, the headache returned full strength within 24 hours of discharge. A few weeks later, on 4/8, we tried a 4 day course of Frova (frovatriptan), to no appreciable effect. The final option seemed to be a lumbar puncture (spinal tap) to see if the headache was attributable to increased intracranial pressure.
Dr. Moein had written us a prescription for biofeedback therapy and referred us to you at our first visit with her. At that time, I was unfamiliar with biofeedback therapy, and was anticipating relief from the preventative medications within a few weeks. As the weeks went by, our concern became that the headache was caused by some physical malady. Toward the end of April, Savannah’s particular headache symptoms did not seem to indicate need for a spinal tap, but were still unrelieved. I felt we were essentially out of options, until I remembered the scrip for biofeedback therapy.
Savannah’s first visit to CBBT was 4/18. Within 11 minutes of beginning the assessment and working with you on the therapy technique, her headache was completely gone. It was the first relief outside of her hospital stays that she had experienced since her headaches began at the end of February. Although the headaches initially returned relatively quickly, she was able to practice the techniques (‘sweeps’) that you taught her, and gain control over her symptoms and her daily routine. In addition to the initial visit on 4/18, you all did a full baseline work up on 4/22, and then she had an additional visit the following week for further training on the technique, along with a couple of telephone sessions in the interim when she was unable to get full relief on her own with the sweeps. Shortly thereafter, I believe the preventative medications she had been taking since 3/4 finally began having some effect, as she was not complaining of headache even when she hadn’t used the sweep technique yet that day. However, any time the headache began to return, or to increase in intensity, she was able to use the sweeps to lessen, or completely eradicate, the pain. Due to the multiplicity of modalities/medications, it is hard to know how much effectiveness to attribute to each, however, I am certain that the biofeedback techniques were the first to help, and that what you are teaching Savannah is essential to her recovery from the existing chronic daily headache pattern within which she was trapped. Certainly they created the perception within her mind that she had some personal control over the problem (We jokingly called the technique ‘summoning her Patronus’ – from the Harry Potter series: The more she practiced, the more proficient she became, and the more confidant she became that she could successfully use the sweeps.) Savannah has been much improved during the past three weeks, and continues to practice her sweeps daily.
I would be happy for you to share this letter of recommendation with any of your potential patients, and would wholeheartedly recommend the technique you have developed. My only regret is that we did not come to you much earlier, and that the technique is not more well-known. Thank you for your developments with this therapy, and your availability and concern, in helping Savannah and our family with what has been a very challenging time.
I want to thank you so very much for helping my son Eric. When he came to you he was being home schooled because his migraines were so bad he had become a prisoner in our own home. The least little noise and he would be in so much pain he couldn’t stand it.
Due to the type of headaches he had, he could not take tryptans and the daily doses of maintenance meds were not helping at all. Thankfully, his neurologist recommended we see you.
He was very skeptical when we started, but after the first half of the first session you were able to help him gain the only relief he had in months! The day I took him to the emergency room for migraine and we called you – that was a remarkable day. While waiting to be seen, he spoke with you for 10 minutes and poof! the headache was gone. We were able to leave the hospital without ever having seen a doctor.
Rusty, you and your skills were a blessing for us. I tell everyone who asks about how my son is doing all about you and your wonderous treatments.
Thank you so much for your help!