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Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy (RSD), also known as Complex Regional Pain Syndrome (CRPS), is an incompletely understood response of the body to an external stimulus.

The end result is pain that is nonanatomic and disproportionate to the inciting event or expected healing response. RSD deals with continuous, intense pain out of proportion to the severity of an injury, which gets worse rather than better over time. It most often affects one of the arms, legs, hands, or feet. Often the pain spreads to include the entire arm or leg. Typical features include dramatic changes in the color and temperature of the skin over the affected limb or body part, accompanied by intense burning pain, skin sensitivity, sweating, and swelling. Doctors aren’t sure what causes CRPS. In some cases the sympathetic nervous system plays an important role in sustaining the pain.

 

Treatment

Treatment of this condition is multifactorial. It is most important to treat it quickly and aggressively before it gets worse. First eliminate an injury if present. Decrease the pain with medications for pain which could include anti-seizure, and antidepressant drugs or steroids, and judicious use of narcotics. Than activity, physical therapy and range of motion exercises are important to begin early and continue throughout the course of treatment. Interventional pain procedures are sometimes necessary such as sympathetic nerve blocks, epidurals, peripheral nerve blocks and in resistant cases a spinal cord stimulator implant becomes necessary.