NINDS Reflex Sympathetic Dystrophy Syndrome Information Page: NINDS
Article title: NINDS Reflex Sympathetic Dystrophy Syndrome Information Page: NINDS
Main condition: Reflex Sympathetic Dystrophy Syndrome
Conditions: Reflex Sympathetic Dystrophy Syndrome
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
6 months 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.
American Chronic Pain Association (ACPA)
P.O. Box 850
Rocklin, CA 95677-0850
ACPA@pacbell.net
http://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
http://www.rsds.org/
Tel:
203-877-3790
Fax: 203-882-8362
RSDHope
P.O. Box 875
Harrison, ME 04040-0875
stonehed@megalink.net
http://www.rsdhope.org/
Tel:
207-583-4589
National Foundation for the Treatment of Pain
1330 Skyline
Drive
#21
Monterey, CA 93940
mgordon@mbay.net
http://www.paincare.org/
Tel:
831-655-8812
Fax: 831-655-2823
Related NINDS Publications and Information
Reflex Sympathetic Dystrophy Syndrome (RSDS)
fact sheet compiled by the National Institute of Neurological Disorders
and Stroke (NINDS).
Information on Sindrome de Distrofia Simpatica
Refleja/Spanish-language fact sheet on RSDS compiled by the National
Institute of Neurological Disorders and Stroke (NINDS).
Chronic pain
information page compiled by the National Institute of Neurological
Disorders and Stroke (NINDS).
Information booklet on
pain compiled by the National Institute of Neurological Disorders and
Stroke (NINDS).
This fact sheet is in the public domain. You may copy it.Provided
by:
The National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD
20892
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