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Reflex Sympathetic Dystrophy (RSD)

Reflex Sympathetic Dystrophy is also known as Complex Regional Pain Syndrome. This is a chronic neurological syndrome. The hallmark of Reflex Sympathetic Dystrophy is pain and mobility problems out of proportion to those expected from the initial injury. The pain can be severe, constant, burning or a deep aching pain. Wearing clothing or a light breeze may be perceived as painful. The skin may appear shiny, dry or scaly. The hair may initially grow coarse and then thin. Nails in the affected extremity may be more brittle, grow faster and then slower. The skin may be either warm or cold to the touch. There may be increased sweating and the skin color can range from a white mottled appearance to a red or blue appearance. Swelling can occur and will be localized to the painful and tender region. Patients with Reflex Sympathetic Dystrophy can also have difficulty moving because they hurt. As time progresses, the pain and symptoms can become more diffuse. The disorder typically starts in the extremity. Reflex Sympathetic Dystrophy may present in three stages. Stage I and II symptoms begin to appear within a year. Some patients never progress to Stage III, which is characterized by marked wasting of tissue that eventually becomes irreversible. For many patients the pain becomes intractable and may involve the entire limb.

The mechanism of Reflex Sympathetic Dystrophy has been described as an original injury that initiates a pain impulse which is carried by sensory nerves to the central nervous system. The pain impulse in turn triggers an impulse in the sympathetic nervous system which returns to the original site of the injury. The sympathetic impulse triggers the inflammatory response causing the vessels to spasm leading to swelling and increased pain. The pain triggers another response establishing a cycle of pain and swelling, burning and extremity pain and red mottling of the skin results.

Ordinarily, the sympathetic nervous system shuts down within minutes to hours after an injury. For reasons physicians do not yet understand, the sympathetic nervous system appears to assume an abnormal function in individuals who develop Reflex Sympathetic Dystrophy.

When one has Reflex Sympathetic Dystrophy, one should use the affected body part as much as possible. Medication, nerve blocks, TENS unit and physical therapy are employed to facilitate movement of the affected region of the body. The goal in physical therapy should be to teach the patient to use their affected body part through activities of daily living. The effects of untreated Reflex Sympathetic Dystrophy can result in extreme pain, chronic pain, disability and unemployment and loss of quality of life.

For related information go to: Chronic Pain Syndrome, Insurance Bad Faith, Nerve Injuries and Pain .

At Cheong, Denove, Rowell & Bennett, we believe the more you know, the better choice you will make.

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