Reflex Sympathetic Dystrophy (RSD) is a pain syndrome that affects any part of the body, most frequently it affects the extremities causing pain in the hands, feet, arms, legs, and knees. It is a source of severe pain and suffering for those with RSD. It is among 100 types of arthritis and rheumatic diseases. RSD is an exaggerated pain response due to nerve stimulation. It is also known as Complex Regional Pain Syndrome. This disease different because it affects nerves, skin, blood vessels, muscles, and bones.

 

Paula Abdul, American Idol Judge, was diagnosed with RSD after a 25 year battle with chronic pain. She was injured in a cheerleading accident at age 17 and has had chronic pain ever since. At one point in her career, she found herself unable to get out of bed due to the loss of use on one side of her body.

 

The pain is characterized by several factors like:

  • burning and stinging
  • hypersensitivity to stimuli (ie. A feather on the skin)
  • motor changes like weakness, tremor, stiffness and decreased range of motion
  • tissue swelling (edema)
  • excessive sweating
  • progressive changes to hair, skin, nails, bones, and muscles
  • increased dysfunction in affected extremity(ies)

Besides affecting the body, psychiatric changes noted are depression, anxiety, fear, and anger. RSD is thought to have multiple causes. Emotional stress can set off symptoms as well as:

  • injuries or fractures
  • surgery
  • stroke
  • diabetes, thyroid disorders
  • heart disease
  • cancer and brain diseases
  • degenerative arthritis
  • shoulder problem
  • infection
  • carpal tunnel
  • certain medications

 

There is a high incidence of puberty and between the ages of 46-52. Women are more susceptible than men at a 4:1 ratio. In children, there is a higher incidence of leg fractures versus arm fractures 5:1. The most common cause is fractures. Approximately 60-80% also have myofascial pain syndrome too.

Diagnosis is based on patient history, physical, x-ray and nuclear bone scans (to detect bone thinning). There are no specific blood tests for RSD.

 

Treatment for RSD includes:

  • Physical Therapy and exercise
  • Psychotherapy to control emotional stress
  • Sympathetic nerve block
  • Spinal Cord Stimulation
  • sympathectomy (severing the nerve)
  • drug pump
  • medications

 

Prognosis varies from person to person. There are many factors and some unknown factors that influence the outcomes of treatment. The earlier the diagnosis is made the better the outcome. Children and adolescents fare better than those diagnosed later in life. In some cases, spontaneous remission occurs. It is important that clients understand that their doctor may not be able to determine the prognosis. Research continues and support groups are available for RSD sufferers. The National Institute of Health provides a listing on their website along with web addresses.