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The return to normal skin temperature regulation

Warning: technical jargon ahead, formatted for computer viewing

Pain specialists call an increasing sensitivity to a varying stimulus "windup" for a quantitative measure of the nervous system functioning.

The experience of “coldness” typically marks transitions in skin temperature.

The incessant feeling of coldness may affect the quality of life after the transition from cooling or from rewarming.

Some describe their unrelenting experience to be like holding ice or like “being burned by a blowtorch”. However, that may abruptly end with a return to normal functioning.


In 2000, infrared photobiomodulation had been shown to prompt the return to normal skin temperatures and the end of disorders such as complex regional pain syndrome (CRPS or RSD).


However, the infrared therapy was inefficient, and the events were rare.

PhotoMed’s team set out to make the variable-wavelength therapy more efficient for helping people with CRPS and other “nothing works” disorders.

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The team focused on finding treatment parameters that might prompt quick events that might mark the switch back to normal functioning.

Thermal imaging lets the practitioner “see” the actual skin temperatures. Treatments could stop upon noticing a rise in temperature.

This example shows well-regulated bilaterally synchronized temperatures throughout the visit. The stability of temperatures before the response distinguishes CRPS from Raynaud’s syndrome. Raynaud’s may allow the circulation to effectively stop with insufficient or no control.

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Today, the practitioner may efficiently learn if their patient responds to the 7 pre-programmed settings in the Vari-Chrome® Pro.

The Instant Verification System evolved along with the variable-wavelength therapy.

The real-time recordings continue to provide an economical means to test concepts and to build upon earlier data.


Thermal imaging lets the practitioner “see” skin temperatures.

Each 2-minute treatment may prompt a response, or not.

When the therapy doesn’t prompt a response, the practitioner may select a different range of wavelengths from the Vari-Chrome® Pro.

The chart show a constant offset of bilateral skin temperatures throughout large changes in the rate of blood circulation. The continuity of the offset illustrates the precision in the coordinated automation of the sensory and vascular systems.

This example tested wavelengths (TX1 and TX2) that had previously been found to be less likely to prompt a warming response in persistently cold hands.

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The practitioner noticed a warming trend during the fourth 2-minute treatment.

Clip: 19 seconds

A "comfort" thermostat?

The team’s neurosurgeon advisor Robert E. Florin, M.D., suggested that the constant offset in temperature shows that the problem might be like a stuck “thermostat”.

However, the “thermostat” appears to affect the experience rather than the actual skin temperature.

The following example illustrates the separation between the experience of coldness and the actual temperatures.


A unilateral response tells a story about temperature and comfort.

Dr. Florin observed this patient, a nurse with CRPS, achieve near-complete relief within 30 minutes. Her relief lasted more than a year and was repeated.

The patient had undergone an experimental ketamine induced coma that provided only temporary relief from her CRPS.

She had arrived with both hands feeling like holding ice. Only her right hand could respond because the nerves in her left hand that control temperature controlling had been surgically abolished.

At the end of the visit, she reported that both hands felt comfortable despite that her left hand had continued to cool.

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Thermal imaging of a unilateral warming response. Lighter gray is warmer. The left hand had had the temperature regulating nerve abolished thus preventing a response. 12 seconds

Dr. Florin was intrigued by recordings that showed the precision of the interacting physiological systems. The next example shows precise bilateral temperature tracking during both the normal warming phase and response.

This patient had just arrived with cold hands from being outdoors. Her discomfort was the significant pain in her left hand at the base of her thumb.

The practitioner didn’t notice the normal warming because the thermal images didn’t appear to change until after the 3rd 2-minute treatment.

The patient reported significant pain relief and a reduction in size of the lump at the painful spot in her hand. Her relief lasted more than a year after the single visit.

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Lighter gray is warmer. The practitioner didn’t notice the normal warming because the thermal images didn’t appear to change until after the 3rd 2-minute treatment.

How might all these responses be the same?

Plotting the charts above on top of each other shows that only one response was not bilateral yet all hands resumed feeling comfortable.

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The comfortable feeling returned without warming of the hand with the surgically abolished thermoregulation. Could the experience of comfort be separate from the skin temperature?

Thermal imaging may help the doctor prevent injuries caused while surgically attempting to diagnose abnormal skin temperatures.

Patients with complex regional pain syndrome (CRPS or RSD) may undergo a diagnostic procedure called a stellate ganglion block (SGB).

Patients with “hot” CRPS may be at risk of a temporary increase in pain from any sympathetic system stimulation, including photobiomodulation.

The SGB has been shown to cause increased pain long term.

The warming gradient toward the tips of the fingers may be large enough for the practitioner to detect by touch without the need for thermal imaging.