How do I tell the difference between DCS and plain old nerve issues?

[HBO MD]

I think it is in fact not uncommon to experience DCS symptoms repeatedly in the same area ; particularly if there is an underlying injury. As to the use of anti inflammatories, they were postulated to be of therapeutic benefit for DCS some time ago, and indeed, the use of more targeted compounds remains under investigation. It was not uncommon to administer aspirin or a non steroidal to a diver pre recompression. The differentiation between it and DCS is akin to the challenge clinicians face when differentiating between heart related pain and indigestion in some cases ; it depends on clinical perspective....history, risk, associated factors, response to medication, etc. Similarly, movement associated pain can exacerbate the pain of DCS if you consider that DCS induces an inflammatory response in the area of injury. Here, the effect of ill fitting gear, the relatively rapid response to meds etc supports the argument against DCS.
However, with a history of musculoskeletal problems it is important to have evaluate whether or not they are a potential risk factor for future DCS, or worth modifying future profiles. Should one curtail their time and depth, for example? I think that's not unreasonable with advancing age, presence of active injuries, the need for ongoing medication. With the capacity to program computers for slightly more conservative profiles it is not difficult.
Just some thoughts.
Safe diving !

 

[khacken]

Thanks for chiming in. This has been an extremely helpful post for me.

HBO, the times that I had pain, if I did not move, there would be no pain at all. It sounds from your post that with DCS, there would still be pain when not moving, but moving the joint, could possibly be more painful.

 

[HBO MD]

Both are inflammatory conditions. So the key lies in the history/story. Muskuloskeletal pain of an inflammatory nature is typically worse at the end of the day, with stiffness in the morning and responds well to anti inflammatories...usually. DCS is less likely to follow this pattern, and more commonly is persistant.
Hope this helps.
Safe diving!