Reflex sympathetic dystrophy (RSD) has been recognized since the Civil War when soldiers reported intense, burning pain that was inconsistent with the seriousness of their injury. Nowadays, reflex sympathetic dystrophy syndrome is considered to be one of two types of complex regional pain syndrome, the other being causalgia. Although symptoms and treatment are similar, reflex sympathetic dystrophy involves nerve damage, while causalgia does not.

Some cases of reflex sympathetic dystrophy are mild and may disappear on their own, while others are more severe and stay for years in spite of treatment.  It’s a difficult condition to diagnose, and patients often have a wide range of questions regarding complex regional pain syndrome, so we’ve put together this fact sheet to help answer them.

Frequency. Reflex sympathetic dystrophy occurs in approximately five percent of injuries to the peripheral nerves, and after some sort of damage, such as a fracture, sprain, or soft tissue injury. Even a minor event, such as getting a vaccination, can cause RSD.

Characteristics. Although minor injuries are often the cause, RSD is accompanied by intense, chronic pain that is out of proportion to the tissue damage.

Cause. RSD is the result of a nervous system response involving misfires that signal constant pain to the patient. However, why some people develop it and others don’t is unknown but thought to be due to a combination of factors.

Symptoms. Persistent pain, abnormal skin color and temperature, swelling (edema) and decreased range of movement are typical of reflex dystrophy syndrome. Osteoporosis can also occur, and in severe cases the flexor tendons cause joints to curl inward.

Diagnosis. While early diagnosis is key to recovery, most cases are only determined by ruling out other causes, thereby delaying treatment. The average person with RDS has seen five doctors before a diagnosis is made.

Occurrence. Two to three times as many women as men get reflex sympathetic dystrophy. The mean age for finding the condition is 42, although it’s been recognized in children as young as three.

Treatment. A wide variety of treatment options are prescribed, usually involving drug protocol and therapy. Among medications used are anti-inflammatories and topical analgesics. Physical and occupational therapy, sympathetic nerve blocks and spinal cord stimulation may also play a role.

Psychology. Once thought to have a psychological component, reflex sympathetic dystrophy is now recognized to be caused by purely physical means. However, patients may develop psychological problems as a result of constant pain or the disbelief of friends, family or co-workers. Anti-depressants can be prescribed, and/or psychological support.

Race. The vast majority of sufferers tend to be white.