Reflex sympathetic dystrophy (RSD) is a chronic pain condition that is believed to be the result of problems in the central or peripheral nervous systems.
Typical features of this condition include dramatic changes in the color and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling.
(Click Causalgia for more information on CRPS II.)
RSD can strike at any age and affects both men and women, although it appears to be more common in young women.
At this point, doctors aren't sure what causes it. In fact, in all likelihood, RSD probably does not have a single cause, but is rather the result of multiple causes that produce similar symptoms.
Researchers are currently looking at certain chemicals in the nervous system and the immune system for possible RSD causes.
The key RSD symptom is continuous, intense pain out of proportion to the severity of the injury, which gets worse rather than better over time.
Besides continuous, intense pain, other symptoms can include:
- "Burning" pain
- Increased skin sensitivity
- Changes in skin texture (shiny and thin and sometimes excessively sweaty)
- Changes in skin temperature (warmer or cooler compared to the opposite extremity)
- Changes in skin color (often blotchy, purple, pale, or red)
- Changes in nail and hair growth patterns
- Motor disability, with decreased ability to move the affected body part
- Swelling and stiffness in affected joints.
Symptoms can vary in severity and length. Some experts believe there are three stages associated with RSD, marked by progressive changes in the skin, muscles, joints, ligaments, and bones of the affected area.
To help make a diagnosis, the doctor will first take a detailed medical history, which includes asking questions about a person's general health, symptoms, family medical history, and history of trauma. The doctor will also do a complete physical exam to check for other signs of RSD and will likely recommend certain tests.
Because there is no cure, treatments for RSD are aimed at relieving painful symptoms so that people can resume their normal lives. The following treatments for RSD may include:
- Psychotherapy
- Physical therapy
- Medications
- Surgical sympathectomy
- Intrathecal drug pumps
- Spinal cord stimulation.
(Click Treatments for RSD for more information.)
The RSD prognosis varies from person to person, and doctors are not sure of the factors that affect the prognosis.
Spontaneous improvement from symptoms occurs in certain people. Others can have unremitting pain and crippling, irreversible changes in spite of treatment for RSD. Some doctors believe that early treatment is helpful in limiting the effects of this condition.
