Reflex sympathetic dystrophy syndrome




Reflex sympathetic (REE-flecks SIM-pah-theh-tick) dystrophy syndrome, or RSDS for short, involves a disturbance in the sympathetic nervous system which is the network of nerves located alongside the spinal cord and controls certain bodily functions, such as opening and closing blood vessels or sweat glands. It primarily affects the hands and feet.


First Stage

  • Affected area is painful and swollen.
  • Changes in temperature and color of skin
  • Rapid nail and hair growth
  • Stiffness

The second stage occurs after weeks or months, and includes the following symptoms:

  • Burning pain
  • Cool skin
  • Brittle nails
  • Swelling
  • Muscles spasms

The third stage may result in permanent changes such as:

  • Severe pain
  • Skin may become drawn.
  • Muscles and other tissues become wasted and contracted (tight).
  • Joint movement and limb function are reduced.


Although the cause is unknown it can occur as a result of injury to nerves, bones, joints, occasionally muscles, tendons or ligaments. Other triggers may include:

  • Infections
  • Cancer
  • Diabetes
  • Disorders of neck/lower back
  • Thyroid disorders
  • Lung disease
  • Stroke/heart attack
  • Use of certain medications


If one can demonstrate major nerve damage associated with the development of RSD / CRPS symptoms, the condition is called complex regional pain syndrome (CRPS) type II or causalgia. Generally, causalgia provides more objective evidence of disease due to neurological changes (numbness and weakness). The terms complex regional pain syndrome (CRPS) type I and type II have been used since 1995, when the International Association for the Study of Pain (IASP) felt the respective names reflex sympathetic dystrophy and causalgia were inadequate to represent the full spectrum of signs and symptoms. 1-8 The term "Complex" was added to convey the reality that RSD and causalgia express varied signs and symptoms. Many publications, particularly older ones, still use the names RSD and causalgia. To facilitate communication and understanding the designation RSD / CRPS is generally used throughout these practice guidelines. The principles applicable to the diagnosis and management of RSD are similar to those principles applicable to the diagnosis and management of causalgia.


An early diagnosis and treatment can help reduce or prevent permanent damage. Treatments may include:

  • Biofeedback
  • Exercise
  • Medications: alpha-blocking drugs, calcium channel blockers, local anesthetic blockers, Bien block
  • Physical therapy
  • Surgery
  • TENS unit (transcutaneous electrical nerve stimulation)