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What is Reflex Sympathetic Dystrophy Syndrome?
Is there any treatment?
What is the prognosis?
What research is being done?

Organizations
Related NINDS Publications

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 bone.

Is there any treatment?
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 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?
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?
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.

P.O. Box 850
Rocklin CA 95677-0850
ACPA@pacbell.net
www.theacpa.org
Tel: 916-632-0922
Fax: 916-632-3208

National Chronic Pain Outreach Association (NCPOA)

P.O. Box 274
Millboro VA 24460
ncpoa@cfw.com
Tel: 540-862-9437
Fax: 540-862-9485

Reflex Sympathetic Dystrophy Syndrome Association (RSDSA)

P.O. Box 502
Milford CT 06460
jwbroatch@aol.com
www.rsds.org
Tel: 203-877-3790
Fax: same

RSDHope/ Maine RSDS Patient Advocacy Group

P.O. Box 875
Harrison ME 04040-0875
stonehed@megalink.net
www.rsdhope.org
Tel: 207-583-4589