About reflex sympathetic dystrophy syndrome

What is reflex sympathetic dystrophy syndrome?

Reflex sympathetic dystrophy syndrome (RSDS), also known as complex regional pain syndrome, is a rare disorder of the sympathetic nervous system that is characterized by chronic, severe pain. The sympathetic nervous system is that part of the autonomic nervous system that regulates involuntary functions of the body such as increasing heart rate, constricting blood vessels, and increasing blood pressure. Excessive or abnormal responses of portions of the sympathetic nervous system are thought to be responsible for the pain associated with reflex sympathetic dystrophy syndrome.

The symptoms of reflex sympathetic dystrophy syndrome typically begin with burning pain, especially in an arm, finger(s), palm of the hand(s), and/or shoulder(s). In some individuals, RSDS may occur in one or both legs or it may be localized to one knee or hip. Frequently, RSDS may be misdiagnosed as a painful nerve injury. The skin over the affected area(s) may become swollen (edema) and inflamed. Affected skin may be extremely sensitive to touch and to hot or cold temperatures (cutaneous hypersensitivity). The affected limb(s) may perspire excessively and be warm to the touch (vasomotor instability). The exact cause of RSDS is not fully understood, although it may be associated with injury to the nerves, trauma, surgery, atherosclerotic cardiovascular disease, infection, or radiation therapy.

What are the symptoms for reflex sympathetic dystrophy syndrome?

Shoulder pain symptom was found in the reflex sympathetic dystrophy syndrome condition

RSD occurs in the extremities. It most commonly affects the upper limbs, but it’s possible to get it in your lower limbs as well. Specifically, you may experience RSD in your:

  • hands
  • fingers
  • arms
  • shoulders
  • legs
  • hips
  • knees

Symptoms include:

  • stiffness
  • discomfort
  • Pain or Burning sensation
  • swelling
  • sensitivity to heat or cold
  • weakness
  • feeling warm to the touch
  • skin redness
  • skin paleness with a blue tone
  • tenderness
  • Sweating around the affected area
  • changes to the skin in the affected area
  • muscle weakness
  • muscle spasms
  • muscle atrophy
  • joint Pain and stiffness
  • nail and hair changes

Most symptoms begin at the site of the condition but may spread as RSD progresses. You may have symptoms on one side but notice them in your opposite limb as the condition worsens. Symptoms may begin as mild and then become more severe, interfering with your daily life.

Your mental health can also be affected with RSD. You may experience anxiety, depression, or post-traumatic stress disorder related to the condition.

What are the causes for reflex sympathetic dystrophy syndrome?

RSD occurs when your sympathetic nervous system and immune system malfunction because of nerve damage. It affects up to 200,000 Americans annually. The damaged nerves misfire, sending your brain excessive signals of pain from the affected area.

According to the National Institute of Neurological Disorders and Stroke, 90 percent of people with CRPS can point to their medical history to determine what caused the condition. Many underlying conditions and factors can lead to RSD, including:

  • trauma, such as fractures, broken bones, or amputation
  • infection
  • soft tissue injuries such as burns and bruises
  • sprains
  • radiation therapy
  • cancer
  • surgery
  • paralysis of one side of the body
  • heart attack
  • emotional stress
  • nerve pressure
  • stroke

You may also experience RSD with no prior medical condition. Your doctor will try to determine the cause of the RSD if this is the case.

What are the treatments for reflex sympathetic dystrophy syndrome?

Early treatment is imperative to stop RSD from worsening or spreading. However, early treatment can be difficult if it takes time to diagnose the condition.

Treatments for RSD vary. Certain interventions and medications may help relieve and treat symptoms. You may also seek physical therapy and psychotherapy to reduce the effects of RSD. You may find that your condition improves dramatically with treatment, but some people have to learn how to manage their symptoms.

Medical procedures

Interventions for RSD include:

  • transcutaneous electrical nerve simulation
  • biofeedback
  • peripheral nerve blocks
  • spinal cord stimulation
  • pump implantation
  • sympathectomy, either chemical or surgical, which destroys some of your sympathetic nerves
  • deep brain stimulation
  • intrathecal (in the spine) drug pumps
  • electroacupuncture


A variety of medications are available for RSD, ranging from over-the-counter pain relievers and topical creams to prescription drugs from your doctor. These medications include:

  • anticonvulsants
  • antidepressants
  • beta-blockers
  • benzodiazepines
  • bisphosphonates
  • guanethidine
  • membrane stabilizers
  • muscle relaxers
  • nonsteroidal anti-inflammatory drugs
  • opioids
  • systemic steroids
  • topical anesthetics
  • vasodilators


Physical therapy may help you rehabilitate the affected limb. This type of therapy will ensure that you continue to move the limb to retain its abilities. It also improves your blood flow and reduces symptoms related to circulation problems. Regular physical therapy may be needed to reduce symptoms.

Seeing a health professional for psychotherapy may also be necessary with RSD. You may develop a psychological condition from the chronic pain associated with the condition. Psychotherapy will help you manage your mental health.

You may also find that complementary alternative therapies like acupuncture or relaxation methods work for treating your RSD.

What are the risk factors for reflex sympathetic dystrophy syndrome?

You may be more susceptible to RSD if you:

  • are between the ages of 40 and 60 years
  • are a woman
  • have other inflammatory or autoimmune conditions

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