An Overview of Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome
Reflex Sympathetic Dystrophy (RSD) is frequently referred to as Complex Regional Pain Syndrome (CRPS). RSD is a multi-symptom syndrome that usually affects the extremities, but may affect virtually any part of the body. The best way to describe RSD is an injury to a nerve or to soft tissue that does not heal normally, and it can be caused by even the slightest of injuries. If left untreated, RSD can spread to all extremities which makes the rehabilitation process difficult. The treatment of RSD is challenging and it can become extremely expensive due to permanent deformities and chronic pain. Patient’s suffering from advanced RSD may have significant psychological and psychiatric problems, and risk developing dependency to narcotics. However, if diagnosed early, doctors can use physical therapy and nerve blocks to cure or lessen the effects of the disease. The incidence of this syndrome is higher in women, especially among the young. A number of factors have been associated with causing RSD, including trauma, heart disease and heart attack, cervical spine or spinal cord disorders, cerebral lesions, infections, surgery, repetitive motion disorder or cumulative trauma.
Pain: The first and primary complaint occurring in one or more extremities is described as severe, constant, burning, and/or deep aching pain
Skin Changes: The skin may appear shiny, dry, or scaly. Hair may grow coarse and thin. Nails in the affected extremity may be more brittle, grow faster and then slower. RSD is associated with a variety of skin disorders including rashes, ulcers, and pustules.
Swelling: Pitting or hard edema is usually localized to the painful and tender region.
Movement Disorder: Patients with RSD have difficulty moving because they hurt when they move. Patients describe difficulty in moving, as though they have stiff joints. Tremors and involuntary severe jerking or extremities may be present. Psychological stress may exacerbate these symptoms. Sudden onset of muscle cramps can be severe and completely incapacitating.
Spreading Symptoms: Initially, RSD symptoms are generally localized to the site of the injury. As time progresses the pain and symptoms tend to spread. Typically, the disorder starts in an extremity.
Bone Changes: X-rays may show wasting of bone or a bone scan may show increased or decreased uptake of a certain radioactive substance in bones after intravenous injection.
Duration of RSD: The duration of RSD varies. In mild cases it may last for weeks followed by remission, but in many cases the pain continues for years and in some cases, indefinitely.