About Reflex Sympathetic Dystrophy
Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome (CRPS) Type I, is a chronic pain syndrome that can affect any part of the body, however, it occurs most frequently in the hands, feet, arms, legs, shoulders or knees. It has been recognized as a distinct clinical condition for over 100 years and has been known by various names including algodystrophy, Sudeck's atrophy, causalgia, and sympathetically-maintained pain.
Reflex sympathetic dystrophy is characterized by:
- Severe, chronic pain often described as stinging or burning
- Sensory abnormalities such as allodynia (pain due to a stimulus which does not normally provoke pain) or hyperesthesia (increased sensitivity to stimuli)
- Motor impairment such as weakness, tremor, stiffness, or decreased range of motion
- Edema (tissue swelling) and hyperhydrosis (excessive sweating)
- Progressive trophic changes to skin, hair, nails, muscle, and bone
- Increasing dysfunction of the affected limb
Reflex sympathetic dystrophy causes great suffering and distress in most patients. In addition to severe pain, which in some people remains chronic and unremitting, patients may also experience serious physical disabilities and reduction in their quality of life that can lead to:
Although the symptoms and clinical features of RSD can vary from patient to patient, the one common cardinal feature that is shared by all patients is severe pain that is disproportionate to the original injury. Reflex sympathetic dystrophy does not exist in the absence of pain.
Currently, there is no single test for the diagnosis of reflex sympathetic dystrophy. Therefore, physicians use both subjective (patient history) and objective (physical examination) methods to establish a diagnosis. Imaging or other tests may be included to confirm the diagnosis or to rule out other conditions.
A variety of other conditions can mimic the signs and symptoms of reflex sympathetic dystrophy and have to be ruled out before a definite diagnosis of RSD can be established. These include:
- Rheumatoid arthritis
- Lumbar or cervical disk herniation
- Peripheral neuropathy, diabetic neuropathy
- Nerve entrapment syndromes (e.g., carpal tunnel syndrome)
- Thoracic outlet syndrome
Currently, there is no cure for RSD because the underlying disease process is not well understood. Treatment, therefore, is aimed at controlling and reducing the severity of the symptoms. In general, early diagnosis and treatment is associated with a more favorable prognosis.
The goals of treatment for reflex sympathetic dystrophy include:
- Controlling and minimizing pain
- Functional rehabilitation of the affected limb
- Managing any psychological deficits, such as depression and anxiety, if present
- Prevention of progression and worsening of RSD symptoms
- Improving the patient's quality of life
Reflex sympathetic dystrophy can be a lifelong condition that can have a significant impact not only on the patient but on family and friends as well. The condition may affect many aspects of the patient's life in varying degrees including:
- Activities of daily living
- Social life
- Personal life
Some adjustments of daily life that RSD patients may have to make include:
- Frequent leave of absence from work or possibly early retirement due to inability or difficulty performing work-related tasks
- Giving up or modifying leisure activities such as hiking, kayaking, traveling
- Modification of exercise regimens
- Foregoing routine activities such as driving or shopping
- Participating in some family activities and outings.
The Medifocus Guidebook on Reflex Sympathetic Dystrophy is a unique, comprehensive patient education resource that contains vital information about Reflex Sympathetic Dystrophy that you won't find anywhere else in a single resource. The Guidebook will answer many of your questions about this condition that your healthcare provider may not have the time to answer. To learn more about the Guidebook, please click here