PainCare Florida Physicians

Reflex Sympathetic Dystrophy (RSD)

PAIN CONDITION

Reflex Sympathetic Dystrophy: Causes, Treatment & Pain Relief

Reflex sympathetic dystrophy (RSD), now known as complex regional pain syndrome (CRPS), is a chronic pain condition that often develops after an injury, surgery or medical event.[1] RSD goes beyond normal healing pain—it’s an overreaction by the body’s sympathetic nervous system that causes severe pain in one or more limbs.[1]

About RSD - Reflex Sympathetic Dystrophy

RSD, or Type I CRPS, is a condition characterized by intense pain triggered by tissue injury without nerve damage, often developing after an injury, surgery, stroke, or heart attack.[2] It typically affects an arm or leg, causing pain, sensitivity to stimuli, and skin changes.[3] RSD is believed to stem from a malfunction in the sympathetic nervous system, disrupting blood flow and temperature regulation, leading to prolonged pain, swelling, and other symptoms.[4] The pain is often more severe than the original injury.

Reflex Sympathetic Dystrophy Symptoms

The severity and duration of RSD symptoms vary from person to person. Symptoms tend to start in the weeks or months following an injury or medical event.

According to the Cleveland Clinic, symptoms of reflex sympathetic dystrophy include:

  • Constant or intermittent pain
  • Burning, stinging or tearing sensations
  • Increased sensitivity to painful stimuli
  • Pain from stimuli that aren’t painful
  • Numbness
  • Skin swelling
  • Decrease function or stiffness of affected limb
  • Skin temperature changes
  • Skin color changes (blotchy, pale, red or bruised-looking)
  • Skin texture changes (excessive sweating or thin and shiny)
  • Nail and hair growth changes

Fight the Flame, a non-profit organization, explains that RSD/CRPS patients may also experience muscle spasms, myoclonic jerking (involuntary movements), memory loss, insomnia and trouble concentrating.

Reflex Sympathetic Dystrophy (RSD) Causes

The exact cause of RSD/CRPS isn’t fully understood, but it often follows an injury, surgery, or other trauma.[3]

Here are some medical events that Healthline says may trigger RSD:

  • Trauma (fractures, broken bones or amputation)
  • Infection
  • Soft tissue injuries (burns and bruises)
  • Sprains
  • Radiation therapy
  • Cancer
  • Surgery
  • Paralysis of one side of the body
  • Heart attack
  • Emotional stress
  • Nerve pressure
  • Stroke

Not everyone with these types of injuries or conditions will develop RSD. Some patients may develop the condition without any notable cause.

RSD/CRPS Pain Management Treatments

Why reflex sympathetic dystrophy occurs in some patients remains a mystery, but it is treatable. Your medical team can collaborate to create a whole-body approach tailored to you. Medications often used to treat RSD include oral steroids, anticonvulsants, antidepressants, NSAIDs, and topical pain relievers.[5]

Treatment may include physical therapy to improve movement and CBT to manage pain and stress.[3] Alternative therapies include biofeedback, acupuncture, meditation, relaxation techniques, heat or cold therapy and gentle exercises like swimming or yoga.[6] If you smoke, it is highly recommended to stop.[6]

Interventional pain management focuses on reducing pain and improving limb function. Early treatment is crucial to prevent worsening pain and limited movement. Combined with medication and alternative therapies, it can restore function, ease discomfort, and reduce reliance on medication.

Interventional pain control procedures for RSD:

  • Sympathetic ganglion nerve blocks
  • Trigger point injections
  • Nerve blocks
  • Peripheral nerve blocks
  • Lumbar Sympathetic Block
  • Stellate Ganglion Block
  • Dorsal Root Ganglion (DRG) Stimulation
  • Spinal cord stimulation (SCS)
  • Epidural steroid injections
  • Radiofrequency ablation (RFA)
  • Intrathecal drug delivery systems (pain pumps)

When to Consult an RSD Pain Care Specialist

Don’t let RSD/CRPS control your life—seek help from a pain specialist if your pain is severe, persistent, or affecting your movement and skin. If pain lingers long after recovery from an injury, surgery or medical issue, early intervention is key to effective treatment. With a holistic approach to pain management, you can manage your symptoms, take charge of your health and live with less pain.

Disclaimer: This webpage was written to provide helpful information about RSD/CRPS and is not meant to diagnose, treat or replace your medical care. If you suspect your pain may be from RSD/CRPS, consult your primary physician or pain specialist.

Resources:

  1. Silver N. Reflex Sympathetic Dystrophy. Healthline [Internet]. Updated June 28, 2017. Accessed January 26, 2025. Available from: https://www.healthline.com/health/neurological-health/reflex-sympathetic-dystrophy
  2. Reflex Sympathetic Dystrophy (RSD) Syndrome. New York State Department of Health [Internet]. Accessed January 26, 2025. Available from: https://www.health.ny.gov/diseases/chronic/reflex_sympathetic/
  3. Complex Regional Pain Syndrome. National Institute of Neurological Disorders and Stroke [Internet]. Published March 8, 2023. Accessed January 26, 2025. Available from: https://www.ninds.nih.gov/health-information/disorders/complex-regional-pain-syndrome
  4. WebMD Editorial Contributors. What Is Reflex Sympathetic Dystrophy Syndrome?. WebMD [Internet]. Accessed January 26, 2025. Available from: https://www.webmd.com/brain/what-is-reflex-sympathetic-dystrophy-syndrome
  5. Caporuscio J. What to know about RSD. Medical News Today [Internet]. Published December 21, 2019. Accessed January 26, 2025. Available from: https://www.medicalnewstoday.com/articles/327366
  6. Complex Regional Pain Syndrome (CRPS). Cleveland Clinic [Internet]. Accessed January 26, 2025. Available from: https://my.clevelandclinic.org/health/diseases/12085-complex-regional-pain-syndrome-crps
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