Reflex Sympathetic Dystrophy

What is RSD?

RSD, or reflex sympathetic dystrophy, is a chronic pain syndrome of the sympathetic nervous system. It usually follows an identifiable event, such as a fracture, torn ligament or crush injury. RSD is also referred to as chronic regional pain syndrome (CRPS).

What Causes RSD?

The sympathetic nervous system is a network of nerves that goes to all of the body’s structures, including muscles, tendons, ligaments, and organs. Its job is to inform the brain and spinal cord when something goes wrong with any of these tissues. For example, if you sprain your ankle, the initial sharp pain is followed by a longer-lasting burning pain. That burning pain is your sympathetic nervous system. While the burning usually stops over time, sometimes it doesn’t. Instead, the sympathetic nervous system’s response will continue running, like a car engine that “diesels” after you turn it off. This is RSD/CRPS.

What are Dystrophy’s Symptoms?

Dystrophy is characterized by persistent burning pain, extreme sensitivity to touch, swelling, excessive sweating, and abnormal skin color. It can be difficult to describe where the pain begins or ends, but people with RSD usually know that weather changes make it worse. Weather-sensitive pain is a major feature of RSD. The painful area may always feel cold, and it usually will be sensitive to touch and cold temperatures. Dystrophy’s hallmark symptoms are abnormal skin color and sweating, and they can progress to swelling, loss of range of motion, and even muscle and bone loss.

How is RSD diagnosed?

Like other complex pain disorders, RSD often goes undiagnosed or is misdiagnosed. For example, many RSD patients are told they have fibromyalgia, because the two disorders have overlapping and shared characteristics. Physicians who are highly experienced with complex pain problems can readily identify dystrophy by its symptoms, and through tests that evaluate skin temperature, blood flow, and bone loss. Unfortunately, many patients visit multiple doctors before being properly diagnosed.

How is Dystrophy Treated?

There is no current ‘cure’ for RSD. Typically, RSD/CRPS is treated by addressing the pain with medication or other medical support. Ideally, doctors would find and treat the problem generating the dystrophy. For example, is there a torn ligament that needs to be fixed? Is there an injury site with hidden infection or impaired blood flow?

Research is being conducted to find better ways to help patients who have RSD. The goal is to help patients find some relief of their pain, or manage the pain while preventing its spread. To learn more about RSD, you can visit the following sites: