Reflex Sympathetic Dystrophy or (RSD), is a hard to diagnose, pain
syndrome that can affect a single limb or several limbs. It can occur
after an injury, but can also be caused by a lesion on the central
nervous system or other unknown causes. It is also called Complex
Regional Pain Syndrome. It usually will affect a hand or a foot, but
can also affect a knee, hip, shoulder or other places on the body. This
condition may result in weakness or shrinking of the affected area. It
is estimated that approximately 10% of the population is afflicted with
RSD. It can appear at any age, but more it is more likely to appear
between 40 and 60.
The symptoms of RSD may advance in three stages.
The first stage is called the acute stage. This is during the first one
to three months and is characterized by swelling, burning pain,
hypersensitivity to touch, higher incidence hair or nail growth in the
affected region and skin color or temperature changes.
The second
stage is the dystrophic stage. This is characterized by continued pain
and swelling. The limb will feel cool to the touch and will look blue.
There can be stiffness of the muscle and muscle shrinkage.These
symptoms normally will occur three to six months after the development
of RSD.
The third stage is the atrophic stage. In this stage, the
skin of the affected limb will become shiny and remain cool. Muscle
stiffness and weakness will continue. In this stage, these symptoms can
spread to another limb.
Because RSD has no cure, treatment is
focused on relieving pain, so that a somewhat normal life may be
resumed. The following treatments are used most often:
Physical
therapy. An exercise program to may be beneficial in keeping the limb
moving so that loss of function is not experienced.
Psychotherapy. RSD can have profound effects such as depression and anxiety
These conditions can increase a person's perception of pain. This will may any type of recovery very difficult.
Sympathetic
nerve block. This can involve either administration of phentolamine
which is a drug that blocks sympathetic receptors, directly into the
vein or injecting an anesthetic next to the spine to block the nerves.
Surgical
sympathectomy. This surgical technique will destroy the nerves that are
causing RSD. It should only be used in people whose pain is
significantly improved by the sympathetic nerve blocks described above.
Spinal
cord stimulation. This involves placing electrodes on the skin, next to
the spinal cord to provide a tingling sensation that goes to the
painful area. This has been highly effective in a lot of people with
RSD.
Medications. Topical analgesics, antiseizure
medications,antidepressants, corticosteroids and opioids have been used
effectively to treat the pain of RSD. However,there has been no drug
discovered that has given permanent improvement in symptoms.
Early
diagnosis is the key to recovery with RSD. Unfortunately, RSD is not a
common diagnosis and is often overlooked by the medical profession. If
you think that you may have RSD, find a doctor who has had success in
treating patients with this condition.