What is Reflex Sympathetic Dystrophy?

RSD is a Complex Disorder of Pain, Altered Sensation and Reduced Motion

Woman suffering from foot pain. France
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RSD (reflex sympathetic dystrophy is a disorder also known as reflex sympathetic dystrophy syndrome, complex regional pain syndrome, causalgia and Sudeck's Atrophy. Regardless of what it is called, it's a is a complex disorder that may develop as a result of injury, surgery or disease. RSD consists of unexplained intense pain in a part of the body which has been injured, and includes altered sensation and reduced motion in the body part affected.

Once thought to be a rare disorder, reflex sympathetic dystrophy occurs in people of all ethnic backgrounds, with women affected twice as often as men. RSD most commonly occurs in adults in their 20s to 50s, but may occur at any age.

Causes of RSD

The exact cause of RSD is unknown; RSD is believed to be the result of dysfunction in the central or peripheral nervous systems. Most commonly caused by injuries, RSD may be caused by triggering an immune response and systems associated with inflammation, such as soreness, swelling or redness. 

Symptoms

Symptoms of RSD often begin days or weeks after an injury, usually in an arm or leg which has been injured. If RSD begins due to disease or surgery, the symptoms are the same. The symptoms may include:

  • unexplained intense pain, out of proportion to the injury
  • swelling
  • altered skin temperature, either warm or cold
  • altered skin color
  • reduced motion of the affected part, and movement makes the symptoms worse
  • sensitivity to touch
  • abnormal sweating
  • stiffness and swelling
  • changes in hair and nail growth

Pain can begin in an arm or leg and spread across the body to other limbs. If you are undergoing periods of stress, such as emotional distress or pressure from work, the symptoms and pain may worsen. 

Diagnosis

Diagnosis of RSD is mainly based on the symptoms present.

There is no specific blood test for RSD, but blood tests can exclude other disorders. Some specialized diagnostic tests may be helpful in confirming the diagnosis of RSD in some individuals. In some cases, your doctor may recommend an X-ray to check for thinning of the bones or patterns in your body. 

Treatment

Early diagnosis and treatment of RSD is best. A pain specialist should be part of the treatment team for an individual affected by RSD. Steroid medications such as prednisone can provide pain relief. Opioid pain medications such as morphine are also effective. Other treatments may include antiepileptic drugs, antidepressants, and creams applied to the skin for treatment of the pain. Some individuals may have pain relief with injection of local anesthetic around nerves to the affected area (nerve block).

Physical and occupational therapy also are important in the treatment of RSD to improve the movement of the affected part of the body.

Outlook

When treated early, many individuals with RSD have relief of symptoms within 18 months.

Others individuals, unfortunately, develop chronic pain and disability. Researchers do not know why some people improve while others do not. It is also not known exactly what causes RSD. Future research will no doubt discover how and why RSD begins, how it develops, and identify those individuals at risk for chronic disease.

Source:

"NINDS Complex Regional Pain Syndrome Information Page." Disorders A - Z. 24 Apr 2009. National Institute of Neurological Disorders and Stroke. 21 Jul 2009

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