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Reflex Sympathetic Dystrophy (RSD) How to Manage the Pain
http://www.painsweb.com/articles/421/1/Reflex-Sympathetic-Dystrophy-RSD-How-to-Manage-the-Pain/Page1.html
By Sam Carson
Published on 03/27/2007
 
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.
Reflex Sympathetic Dystrophy (RSD) How to Manage the Pain
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.