Reflex sympathetic dystrophy syndrome
What is Reflex Sympathetic Dystrophy Syndrome?
Reflex sympathetic dystrophy syndrome (RSDS) is a chronic condition
characterized by severe burning pain, pathological changes in bone and
skin, excessive sweating, tissue swelling, and extreme sensitivity to
touch. The syndrome is a nerve disorder that occurs at the site of an
injury (most often to the arms or legs).
It occurs especially after injuries from high-velocity
impacts such as those from bullets or shrapnel. However, it may occur
without apparent injury. One visible sign of RSDS near the site of injury
is warm, shiny red skin that later becomes cool and bluish. The pain that
patients report is out of proportion to the severity of the injury and
gets worse, rather than better, over time.
Eventually the joints become stiff from disuse, and the
skin, muscles, and bone atrophy. The symptoms of RSDS vary in severity and
duration. The cause of RSDS is unknown. The disorder is unique in that it
simultaneously affects the nerves, skin, muscles, blood vessels, and
bones. RSDS can strike at any age but is more common between the ages of
40 and 60, although the number of RSDS cases among adolescents and young
adults is increasing.
RSDS is diagnosed primarily through observation of the
symptoms. Some physicians use thermography to detect changes in body
temperature that are common in RSDS. X-rays may also show changes in the
Is there any
treatment for Sympathetic Dystrophy Syndrome?
Physicians use a variety of drugs to treat RSDS. Elevation of the
extremity and physical therapy are also used to treat RSDS. Injection of a
local anestheticis usually the first step in treatment. TENS (transcutaneous
electrical stimulation), a procedure in which brief pulses of electricity
are applied to nerve endings under the skin, has helped some patients in
relieving chronic dystrophy pain. In some cases, surgical or chemical sympathectomy
-- interruption of the affected portion of the sympathetic nervous system
-- is necessary to relieve pain. Surgical sympathectomy involves cutting
the nerve or nerves, destroying the pain almost instantly, but surgery may
also destroy other sensations as well.
What is the
prognosis for Sympathetic Dystrophy Syndrome?
Good progress can be made in treating RSDS if treatment is begun early,
ideally within three months of the first symptoms. Early treatment often
results in remission. If treatment is delayed, however, the disorder can
quickly spread to the entire limb, and changes in bone and muscle may
become irreversible. In 50 percent of RSDS cases, pain persists longer
than 6months and sometimes for years.
What research is being
done about Sympathetic Dystrophy Syndrome?
Investigators are studying new approaches to treat RSDS and intervene more
aggressively after traumatic injury to lower the patient's chances of
developing the disorder. Scientists are studying how signals of the
sympathetic nervous system cause pain in RSDS patients. Using a technique
called microneurography, these investigators are able to record and
measure neural activity in single nerve fibers of affected patients. By
testing various hypotheses, these researchers hope to discover the unique
mechanism that causes the spontaneous pain of RSDS, and that discovery may
lead to new ways of blocking pain.
American Chronic Pain Association (ACPA)
P.O. Box 850
Rocklin CA 95677-0850
National Chronic Pain Outreach Association (NCPOA)
P.O. Box 274
Millboro VA 24460
Reflex Sympathetic Dystrophy Syndrome Association (RSDSA)
P.O. Box 502
Milford CT 06460
RSDHope/ Maine RSDS Patient Advocacy Group
P.O. Box 875
Harrison ME 04040-0875
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© Anthony George 2005 Sympathetic Dystrophy Syndrome Sponsor Love My Town