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Reflex Sympathetic Dystrophy

What is Reflex Sympathetic Dystrophy?


Reflex sympathetic dystrophy syndrome, more commonly called RSD, is an often misunderstood chronic neuro-inflammatory syndrome frequently associated with debilitating pain. The condition is also known as Complex Regional Pain Syndrome, or CRPS, with reports of the earliest cases dating back as far as the American Civil War.


The medical community still has much to learn about this disease, which is often mistaken for other conditions. RSD, however, is not a psychological disorder, as some believe; it is an actual medical condition accompanied by genuine pain that is often severe and long-lasting. The Social Security Administration recognizes RSD as a potentially disabling disease. While the right treatment course can help alleviate the symptoms of RSD and sometimes put the disorder into remission, there is currently no known cure for the condition.


While RSD is classified as a rare disorder by the United States Food and Drug Administration, it is estimated that at least 200,000 individuals throughout the United States suffer from this condition in any given year. Because the disorder can be difficult to diagnose, the numbers could actually be higher. RSD is more common in women than men.


The condition occurs when the nervous system and the immune system malfunction as they respond to tissue damage from trauma, such as a fall or a sprain. The nerves misfire, sending constant pain signals to the brain.


According to the Reflex Sympathetic Dystrophy Syndrome Association of America, RSD spreads to other parts of the body in some of the reported cases.


What Causes RSD?


RSD syndrome, which usually affects an arm or a leg, typically develops after an injury, surgery, stroke or heart attack. The pain is usually out of proportion to the severity of the initial injury. There are also some cases where patients developed RSD without an identifiable precipitating injury or medical event.


The condition can be triggered by a broken bone, nerve injury or other soft tissue injuries that does not follow a normal course of healing. RSD may occur in 1% to 2% of all fractures. It has a higher occurrence in people who suffered a Colles fracture of the wrist, which is a fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist and hand that commonly occurs when people try to break a fall by stretching out their arms.


A common myth about RSD is that it only results from catastrophic injury. In fact, RSD frequently results from minor injuries, such as sprains or falls. Prolonged immobilization of a limb, through a cast or other means, is another cause of RSD. It may also occur in individuals after competently performed surgeries.


Medical professionals recognize two RSD subgroups: Type I and Type II. This distinction is based on the treating physician’s ability to identify an underlying nerve injury.


In Type I cases, the individual suffered no specific underlying nerve injury.


In Type II (sometimes called causalgia), there was a distinct major nerve injury at the start of the condition.


RSD can develop long after an injury occurs; in some cases, it can take several months or longer for RSD symptoms to appear.


Symptoms of RSD


Symptoms of RSD vary among individuals and may change over time, which can make it difficult to diagnose. In most cases, according to the Mayo Clinic, the first signs to appear are pain, swelling, redness, noticeable changes in the temperature of the skin and hypersensitivity (particularly to cold and touch).


After the initial symptoms appear, the affected limb can become cold and pale. There may be changes in the skin and nails as well as muscle spasms and tighten. These changes usually signify that the condition is irreversible.


RSD may occasionally spread from its source to elsewhere in the body; for example, to the opposite limb. The pain may be worsened by emotional stress, although it is important to note that RSD is a physical, not a psychological, disorder.


While there is no simple test to determine whether a patient has RSD, the most common symptoms of the disorder include:


  • Severe burning pain or pain that is cold, deep and aching
  • Increased skin sensitivity in the affected area, pain from everyday stimuli such as clothing or a shower
  • Pathological changes in bone and/or skin
  • Excessive sweating, especially in the affected area
  • Abnormal swelling in the affected area
  • Movement disorders that include tremors, spasms, hyper-reflexes, and/or difficulty with movement
  • Frequent infections
  • Recurrent migraine headaches
  • Pain that worsens instead of improving as time goes on
  • Pain that is more severe than one would typically expect from the original injury
  • Abnormal hair or nail growth, loss of hair in the affected area
  • Abnormal skin color changes
  • Abnormal skin temperature, where one side of the body is warmer or colder than the other
  • Limited range of motion, weakness or other motor disorders such as paralysis or dystonia (involuntary muscle contractions)


Because the symptoms vary so widely from patient to patient, it is important to choose a physician who has experience with RSD in order to obtain a proper diagnosis and appropriate treatment.


Treatment for RSD


Research has shown that early diagnosis generally results in more favorable outcomes.


Several different treatments are available for victims of RSD. If you believe you may suffer from this condition, you should seek treatment immediately from a competent physician. Treatment options include medication, physical therapy, psychological support, pain management support, sympathetic nerve blocks, sympathectomy, dorsal column stimulator, and other possible approaches to combating the disease. Even if treated early and properly, the disease may be chronic and the pain may worsen.


RSD and Medical Malpractice


If you or a loved one develops RSD because of medical negligence, it may be possible to file a lawsuit and recoup compensation for long-term medical expenses, lost wages and future earning capacity, rehabilitation, emotional distress and pain and suffering.


Some examples of medical mistakes that could cause RSD are:


  • Unnecessary surgery
  • An injection that was administered in the wrong location
  • An IV infiltration that went unnoticed for too long
  • Failure to diagnose a patient with RSD, causing the condition to worsen and become irreversible
  • Incorrect or delayed treatment of RSD or failure to treat the condition once it has been diagnosed
  • An improperly applied or monitored cast


Because RSD is a complicated condition with a wide variety of causes and symptoms, it is critical to consult a law firm with knowledge and experience in cases that involve medical malpractice.


If you or a family member suffers from Reflex Sympathetic Dystrophy (RSD) or CRPS, contact us as soon as possible for a free consultation.