Reflex Sympathetic Dystrophy (RSD): Symptoms, Diagnosis & Treatment

Overview 

Imagine experiencing sharp pain while performing daily activities like showering or wearing clothes. We may wince at the thought of it, but it could be a sign of a condition known as Reflex Sympathetic Dystrophy Syndrome (RSD).

Let’s understand more about the condition in this blog.  

What is Reflex Sympathetic Dystrophy Syndrome (RSD)? 

Reflex sympathetic dystrophy syndrome (RSD) is a condition that causes chronic pain, typically in the arm or leg, after an injury, stroke, or even a heart attack. However, the pain is usually more severe than the injury itself. Although the condition is treatable in most cases, doctors are unsure of the exact cause. 

The term reflex sympathetic dystrophy syndrome is actually not a name that doctors use anymore. It’s an older term used to describe one form of Complex Regional Pain Syndrome (CRPS). RSD is sometimes called Type I CRPS, and it’s caused by injury to tissue with no related nerve damage.

Why does RSD occur? 

According to doctors, issues with your sympathetic nervous system are the source of the pain for RSD. Your sympathetic nervous system governs your bodily functions, such as heart rate, blood flow, and blood pressure. It also instructs your blood vessels to become contracted to prevent blood loss at the injury site. As time progresses, the sympathetic nervous system instructs your blood vessels to reopen and restore the blood flow to the injured area. 

However, if you suffer from RSD, your sympathetic nervous system receives conflicting messages. RSD may result from various injuries, including amputation, bruises, burns, cuts, sprains, fractures, surgery, or radiation therapy. Even though it’s rare, RSD can occasionally develop without an injury. After an injury, it may constrict your blood vessels but may not reopen them, thus, making your wounded site extremely painful and swollen. 

RSD affects women slightly more frequently than it does men. Children can also get it. However, in adults, it often manifests between 30 and 60 years. 

What are the Symptoms of RSD? 

When you have RSD, your symptoms can take time to manifest. Pain may progressively worsen. At first, you might not be aware that your discomfort is abnormal. But RSD most frequently appears in the arm, shoulder, leg, or hip. Usually, the pain radiates from the place of your injury. In some circumstances, symptoms may even spread to other body areas. 

RSD may also impact your immune system, leading to redness, inflammation, and warm skin near the injury. When you have RSD, your pain is typically intense and ongoing. Patients describe the RSD pain as burning, aching, deep and throbbing. If you have RSD, the actions that don’t bother you otherwise, like taking a shower or wearing clothes, may cause intense pain. 

Other RSD signs and symptoms include: 

• changes in your skin’s texture or hair and nail growth 
• excessive sweating in specific body parts 
• muscles that are weak and spasm frequently 
• rigid joints 
• difficulty moving the affected area 
• changes in skin colour. It may turn into a white, red, or blue 

What are the Diagnostic Methods for RSD? 

Often, it takes some time for doctors to recognize that RSD is the source of your pain. The first sign that it may be RSD is when pain doesn’t go away or is worse than it should be for your type of injury. 

No tests can definitively determine whether you have RSD. However, a physical examination and information about your medical history may be helpful for the healthcare provider to make the correct diagnosis. A few tests can also reveal information on whether you are showing particular symptoms of the disorder. These consist of the following: 

1. Bone scan: With the use of this test, your doctor can find out if any of your bones are wearing down at the ends or if there is a disruption in the normal blood flow.
2. Thermography test: By testing your sympathetic nervous system, you can determine whether the temperature or blood flow at the site of your injury differs from other sections of your body. 
3. MRI: An MRI may be prescribed by your doctor to examine the tissues in your body for any obvious changes. 
4. Sweat test. Your doctor can use this test to determine whether you perspire more on one side of your body than the other. 

What are the Treatment Options for RSD? 

Although no known treatment for RSD exists, therapy can alleviate many symptoms. The therapy of RSD depends on if the condition was diagnosed early or not. The earlier the diagnosis, your treatment will show better results. RSD treatments are ineffective in certain patients. 

Some of the medicines the healthcare provider may suggest are: 

• Lidocaine-based anesthetic creams
• antidepressants, and nonsteroidal anti-inflammatory medicines (NSAIDs) 
• Anti-seizure drugs that could alleviate pain 
• Nasal spray for treating bone thinning 
• Nerve blocking  injections
• Pain relievers include aspirin, ibuprofen, and naproxen. 

The following treatment options are not used or less frequently due to their potential side effects or the lack of evidence demonstrating their effectiveness

• Corticosteroids such as methylprednisolone or prednisolone to treat swelling
• Opioids, such as fentanyl, hydrocodone, morphine, and oxycodone.

Other symptom management strategies include: 

• Insertion of electrodes on the spinal cord that delivers brief electric shocks to ease the pain
• Physical therapy enables better movement and pain management
• Psychotherapy teaches you to relax 
• Splints for pain relief in the hands 

Your doctor may recommend a procedure known as a sympathectomy if your discomfort doesn’t seem to improve while receiving treatment. A surgeon performs this operation to help enhance blood flow by removing some of the nerves surrounding your blood vessels. 

Conclusion 

Early detection and treatment may reduce your symptoms of RSD and enable you to resume your regular activities. On the other side, your symptoms may worsen if there is a delay in getting a prompt diagnosis. Learning the concept of symptom management is a better way for RSD patients to have a good quality of life.  

Frequently Asked Questions (FAQs) 

Is it possible to prevent RSD? 

There are no preventive measures for RSD. But staying active after a stroke or heart attack may reduce your chance of getting it. Taking Vitamin C after a fracture may also help. 

What are the factors that put you at risk of developing RSD?

The following are the risk factors that can put you at a higher risk of developing RSD:

• Age: If you are between the age group of 40 to 60 years
• Sex: Women are more prone to RSD than men
• Other health conditions: If you are suffering from other health conditions, such as inflammatory or autoimmune disorders