Reflex Sympathetic Dystrophy (RSD) Syndrome

[Complex Regional Pain Syndrome (CRPS)]

What is Reflex Sympathetic Dystrophy (RSD) Syndrome?

RSD is an older term used to describe one form of Complex Regional Pain Syndrome (CRPS). Both RSD and CRPS are chronic conditions characterized by severe burning pain, most often affecting one of the extremities (arms, legs, hands, or feet). There are often pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch, known as allodynia.

RSD is sometimes called Type I CRPS, which is triggered by tissue injury where there is no underlying nerve injury, while Type II CRPS refers to cases where a high-velocity impact (such as a bullet wound) occurred at the site and is clearly associated with nerve injury. Type II used to be called "causalgia" and was first documented over 100 years ago by doctors concerned about the pain that Civil War veterans suffered even after their wounds had healed. RSD is unusual in that it affects the nerves, skin, muscles, blood vessels and bones at the same time.

What are symptoms of RSD/CRPS?

The key symptom is, chronic, intense pain that is out of proportion to the severity of the injury (if an injury occurred) and which gets worse over time rather than better. It most often affects the arms, legs, hands or feet and is accompanied by:

  • burning pain
  • increased skin sensitivity to touch
  • changes in skin temperature: warmer or cooler compared to the opposite extremity
  • changes in skin color: often blotchy, purple, pale or red
  • changes in skin texture: shiny and thin, sometimes excessively sweaty
  • changes in nail and hair growth patterns
  • swelling and stiffness in affected joint
  • motor disability, with decreased ability to move affected body part

What causes RSD?

The cause of RSD is not known. The condition is thought to be a malfunctioning of the sympathetic nervous system, but some researchers are questioning this. Since RSD most often follows trauma to the extremities, some conditions that can trigger RSD are sprains, fractures, surgery, damage to blood vessels or nerves and certain brain injuries.

How is RSD diagnosed?

There is no single laboratory test to diagnose RSD. Sometimes imaging studies (x-rays, MRI) or nerve conduction tests are useful, Diagnosis can be made by the healthcare provider when certain conditions are met, including the absence of any other diagnosis that better explains the signs and symptoms. Early diagnosis is thought to be important in preventing progression of the syndrome.

How is RSD treated?

Physical therapy is a primary component of treatment. There also are several types of medications that can be used. Surgical procedures may also help reduce symptoms. Treatment plans are individualized and often incorporate several of these measures.

Is there a cure?

There's no cure at this time, but research continues. Advances have resulted in some new and effective treatments. Some patients may experience a remission of symptoms.

For more information on RSD/CRPS contact the following organizations:

National Institute of Neurological Disorders & Stroke

National Institute of Health

Reflex Sympathetic Dystrophy Syndrome Assn.

Tel: 877-662-7737

American RSDHope Group

Tel: 207-583-4589

American Chronic Pain Assn. (ACPA)

Tel: 800-533-3231

Revised: February 2015