What Is RSD: The Disorder That Has Doctors Baffled

What RSD stands for and what it means. Reflex Sympathetic Dystrophy Syndrome affects the nervous system and can cause severe pain.

Reflex Sympathetic Dystrophy Syndrome, now more commonly known as Complex Regional Pain Syndrome, is a disorder of the sympathetic nervous system. This network of nerves, located alongside the spinal cord, controls certain functions in our bodies, such as the opening and closing of blood vessels and sweat glands.

Though Reflex Sympathetic Dystrophy Syndrome can affect anyone, it is most common in women over the age of 50. However, studies have shown cases of Reflex Sympathetic Dystrophy Syndrome increasing among adolescents and young adults.

Reflex Sympathetic Dystrophy Syndrome often follows an injury, especially an injury from high-velocity impacts such as those from bullets or shrapnel. However, Reflex Sympathetic Dystrophy Syndrome may occur without apparent injury; and in 30% of the cases, the cause is unknown. Minor injuries, such as a sprain or a fall, are frequent causes of Reflex Sympathetic Dystrophy Syndrome; and some patients develop the disorder after having undergone surgery.

Reflex Sympathetic Dystrophy Syndrome is unique in that it affects the nerves, skin, muscles, blood vessels and bones simultaneously. While Reflex Sympathetic Dystrophy Syndrome often affects the hand or foot, the disorder may also involve the knee, hip, shoulder or other sites. Reflex Sympathetic Dystrophy Syndrome spreads in 70% of patients. Thus, if it begins in a hand, it may continue up the arm into the shoulder.

Reflex Sympathetic Dystrophy Syndrome is generally divided into three stages of progression. In the initial stage, the patient feels extreme or lingering pain, usually burning in nature. The pain most often begins in the hand or foot, but it isn't unusual for the pain to be in the hand and shoulder of the same arm or in the foot and knee of the same leg. Some patients experience changes in the temperature and color of the skin at the affected area. Some report rapid hair and nail growth. Most lose the ability to move affected joints normally.

In the second stage of Reflex Sympathetic Dystrophy Syndrome, the patient's pain is often exacerbated by changes in temperature, air conditioning or breezes, or even by a light touch. The skin at the affected area becomes cool to the touch, and the nails become brittle. The affected area may become pale and waxy; and the pain may begin spreading. Often the spreading pain causes muscle spasms. X-rays taken during the second stage of Reflex Sympathetic Dystrophy Syndrome show thinning or damaged joints or bones.

Permanent changes may result during the third stage of Reflex Sympathetic Dystrophy Syndrome. The skin of the affected area becomes drawn, and the muscles and other tissues become wasted and tight. Joint movement is greatly impaired. While the pain may remain severe, some patients report a lessening of pain during this stage.

Reflex Sympathetic Dystrophy Syndrome is poorly understood by patients, their families and health care professionals. It is commonly misdiagnosed as rheumatoid arthritis, infection, gout, or some other disorder. Reflex Sympathetic Dystrophy Syndrome is not a psychological disease. A common characteristic of the disorder is that the pain is more severe than expected for the type of injury suffered.

Another misconception about Reflex Sympathetic Dystrophy Syndrome is that it is a recently discovered disease. In fact, the condition was described in medical records prepared during the American Civil War (solders were reported to be suffering from nerve wounds to the extremities) and has been recorded under a variety of names since.

Early treatment of Reflex Sympathetic Dystrophy Syndrome is crucial to success and may include medication, sympathetic nerve block, physical therapy, and possibly dorsal column stimulation. Early treatment often results in remission.

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