Reflex Sympathetic Dystrophy

Reflex Sympathetic DystrophyReflex sympathetic dystrophy (RSD) is a medical condition that affects the patient’s sympathetic nervous system. RSD is characterized by severe chronic pain in an affected region, such as a patient’s arm or leg. After the onset, RSD will continue to worsen as time passes.

RSD is a debilitating and painful condition that has a significant impact on the patient’s daily life. While there is no cure, a number of treatments may be administered to relieve RSD symptoms. If treated early, patients typically have a better outcome.

What Is the Sympathetic Nervous System?

In order to investigate and better understand Reflex Sympathetic Dystrophy, it is helpful to first understand the sympathetic nervous system. The sympathetic nervous system is one of the three main parts of the autonomic nervous system. The other two parts of the autonomic nervous system include the parasympathetic and
enteric systems.

This system regulates bodily functions such as constricting blood vessels, heart rate, and increasing blood pressure. While the association is not completely known, many believe that abnormal or excessive responses of sympathetic nervous system portions are the cause of RSD pain.

Symptoms of RSD

RSD is known to cause severe, chronic pain. For many patients, the condition is debilitating. As RSD progresses, patients may lose function of the affected area and experience an overall decrease in quality of life. RSD pain typically begins in a localized area. As the condition progresses, the pain may spread throughout the entire limb or to other limbs.

Symptoms of RSD may include:
• A severe burning or stinging pain
• Intense sensitivity to pain
• Changes in skin color, texture, and temperature
• Changes in hair and nail growth patterns
• Stiffness and swelling in joints of the affected area
• Issues with the ability to move the affected limb

Causes of RSD

The exact cause of RSD in each case may not be identified. In roughly one-third of RSD cases, medical professionals could not identify or associate an inciting event. However, data suggests a number of
incidences and conditions that may contribute or act as risk factors for development of RSD.

Many believe that RSD is caused by abnormal excitation and irritation of the patient’s nervous tissue. This in turn may cause abnormal impulses within the nerves that affect the patient’s skin and blood vessels. The patient’s brain, peripheral nerves, and involuntary nervous system are also thought to be involved.

Many believe that RSD may be triggered by events such as:
• Injury, trauma, or surgery in a specific area of the affected limb
• Heart disease or stroke
• Nerve irritation due to entrapment, such as in carpel tunnel
• Degenerative arthritis of the neck
• Drugs that treat tuberculosis and barbiturates

RSD Prognosis and Treatment

There is no known cure for RSD. However, a number of treatments and therapies exist to help relieve RSD symptoms. RSD prognosis is more favorable for patients who receive early diagnosis and treatment for RSD. If treatment is administered in the early stages of the disorder, permanent damage and loss of mobility may be decreased.

Treatment for RSD may include a number of therapies, including:
• Over-the-counter and prescription strength pain relieving drugs
• Physical therapy to promote mobility and decrease pain and tension
• Surgical procedures to cut and seal affected nerves
• Nerve-block treatments, which involve anesthetic injections into affected nerves
• Alternative therapy, such as nutritional supplementation, herbal pain remedies, acupuncture,
and stress-relieving meditation


RSD may be confused with complex regional pain syndrome (CRPS). The most recent definition of these
conditions indicates that RSD and CRPS Type I refer to the same condition. However, CRPS Type II is not
characterized as RSD.

The main difference is that RSD and CRPS Type I involve primary damage to soft tissue. CRPS Type II is
defined as involving damage a patient’s major nerve. It should be noted that the term RSD is being
phased out in favor of CRPS when referring to this condition.


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Orthopaedic Surgeons. Web. 2 Aug 2013. http://orthoinfo.aaos.org/topic.cfm?topic=a00021.
Marshall, A.T., and A.J. Crisp. “Reflex sympathetic dystrophy.” Rheumatology. 39.7 (2000): 692-695. Print.

“Reflex Sympathetic Dystrophy (RSD) Syndrome.” New York State Department of Health. New York State
Department of Health, n.d. Web. 2 Aug 2013.

“Reflex Sympathetic Dystrophy Syndrome.” UW Medicine: Orthopaedics and Sports Medicine. University
of Washington. Web. 2 Aug 2013. http://www.orthop.washington.edu/?q=patientcare/articles/arthritis/reflex-sympathetic-dystrophy-syndrome.html.