Synonym(s): Complex Regional Pain Syndrome, Causalgia
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Studies with patientsTable of Contents (click to jump to sections)
What is Reflex Sympathetic Dystrophy Syndrome?
Is there any treatment?
What is the prognosis?
What research is being done?
Organizations
Related NINDS Publications and Information
Additional resources from MEDLINEplus
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 6months 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.
Select this link to view a list of studies currently seeking patients.
OrganizationsAmerican Chronic Pain Association (ACPA)
P.O. Box 850
Rocklin, CA
95677-0850
ACPA@pacbell.net
http://www.theacpa.org
Tel: 916-632-0922
800-533-3231
Fax: 916-632-3208
National Chronic Pain Outreach Association
(NCPOA)
P.O. Box 274
Millboro, VA
24460
ncpoa@cfw.com
http://www.chronicpain.org
Tel: 540-862-9437
Fax: 540-862-9485
Reflex Sympathetic Dystrophy Syndrome Association
(RSDSA)
P.O. Box 502
Milford, CT
06460
info@rsds.org
http://www.rsds.org
Tel: 203-877-3790
Fax: 203-882-8362
American RSDHope Group
P.O. Box 875
Harrison, ME
04040-0875
rsdhope@mail.org
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
American Pain Foundation
201 North Charles Street
Suite 710
Baltimore, MD
21201
info@painfoundation.org
http://www.painfoundation.org
Tel: 888-615-PAIN (7246)
410-783-7292
Fax: 410-385-1832
National Headache Foundation
820 N. Orleans
Suite 217
Chicago, IL
60610
info@headaches.org
http://www.headaches.org
Tel: 773-388-6399
888-NHF-5552 (643-5552)
Fax: 773-525-7357
Mayday Fund [For Pain Research]
c/o SPG
136 West 21st Street, 6th Floor
New York, NY
10011
MaydyFnd@aol.com
http://www.painandhealth.org
Tel: 212-366-6970
Fax: 212-838-2896
Related NINDS Publications and InformationWorkshop on Reflex Sympathetic Dystrophy
A workshop on Reflex Sympathetic Dystrophy/ Complex Regional Pain Syndromes (CRPS): State-of-the-Science, December 15, 2001.
Reflex Sympathetic Dystrophy Syndrome Fact Sheet
Reflex Sympathetic Dystrophy Syndrome (RSD/CRPS) fact sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
La Distrofia Simpática Refleja/El Síndrome de Dolor Regional Complejo
Informacion de la Distrofia Simpática Refleja/el Síndrome de Dolor Regional Complejo/Spanish-language fact sheet on Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome (RSDS/CRPS), compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
Chronic Pain
Chronic pain
compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
Pain: Hope Through Research
Information booklet on pain compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
Provided by:
The National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
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