What is Reflex Sympathetic Dystrophy?

Reflex sympathetic dystrophy is a rare disorder of the sympathetic nervous system. It is characterized by chronic severe burning pain usually in the arms, fingers, palm of hand, shoulder, or legs. If untreated, the pain and weakness that RSD may cause limited use of the injured region.

Reflex sympathetic dystrophy (RSD) is also known as complex regional pain syndrome (CRPS, Type 1). CRPS type 2 was formerly called causalgia.  RSD or CRPS-1 is the term used when there is no prior nerve injury.  CRPS-2 is used when there has been prior nerve injury. Both have the same symptoms and clinical picture.

What triggers RSD?

The cause of RSD is unknown. CRPS-2 may be caused by injury. Getting injured may trigger RSD. It can be something minor, like a sprain or a cut. Or, it may be more severe, like a fracture or a surgery, such as carpal tunnel release. As you’re healing, you may feel new, severe pain in the injured region. That pain may spread through the injured limb. Over time, other symptoms may appear.

Symptoms and signs of RSD

If you aren’t treated soon, the symptoms of RSD can worsen or change over time. Below are symptoms and signs that can occur in the injured region:

Early-stage RSD

Symptoms include:

  • Prolonged, severe, burning pain

  • Sensitive to touch (pain from physical contact that normally would not be painful) 

  • Swollen, blotchy, reddish or purple look

  • Stiffening joints

  • Change in temperature to the affected body part as compared to the other limb

  • Abnormal sweating pattern in the affected or surrounding areas 

Late-stage RSD

Symptoms include:

  • Skin slowly withering

  • Skin that appears shiny and thin

  • Loss of strength

  • Changes in hair and nail growth patterns

  • Ridges in skin look flatter than normal

  • Shrinkage of the affected limb

  • Constant swelling of the foot or hand

  • Spreading to other limbs

  • Abnormal movements of the involved extremity such as poor coordination, tremor, and involuntary movements