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Help With RSD

Reflex sympathetic dystrophy syndrome, or RSD, is a disorder characterized by chronic, intense pain that may not have a specific corresponding cause. It results from overactivity in the sympathetic nerve, which controls blood flow and sweat glands in the arms and hands. RSD most typically affects a single limb, and is the most common form of a larger disorder known as complex regional pain syndrome (CRPS). Effective treatment for the condition varies from individual to individual.

  1. Understanding Your RSD Symptoms

    • According to the American Academy of Orthopedic Surgeons, your RSD symptoms will typically advance in three stages. Stage one lasts up to three months, and during this time you will experience intensifying pain, swelling, warmth, and abnormal sweat production in your affected limb. This may be accompanied by joint pain and stiffness during movement, and unusually rapid growth of your hair and nails. In stage two, which lasts three months to a year, your swelling will intensify and the natural wrinkles in your skin will disappear. Additionally, the temperature of your skin will drop, and your pain and stiffness will worsen and spread. Stage three, which may extend indefinitely, is characterized by shiny, pale skin that is stretched tight. While your pain may decrease, you may experience a permanent decrease in mobility.

    Medications

    • Successful treatment of your RSD depends on proper diagnosis before your condition reaches an advanced stage. Typically, your doctor will create an individual treatment plan to address your particular circumstances. Any ongoing inflammation-related pain you experience may be treated with aspirin or a nonsteroidal anti-inflammatory (NSAID) medication such as ibuprofen, indomethacin, or naproxen. Sharp or sudden pains may be addressed with anticonvulsants such as pregabalin or carbamazepine, or antidepressants such as doxepin, nortriptyline, or amitriptyline. If you have severe pain that cannot be controlled through other means, your doctor may prescribe an opioid compound such as codeine, morphine, or propoxyphene. You may also receive an opioid-like medication called tramadol. Consult your doctor for a full explanation of the risks and benefits of any medication he may prescribe.

    Nerve Block and Surgery

    • The pain of RSD can also be relieved through a technique called a nerve block. In this procedure, an experienced physician will inject a type of anesthesia called an alpha-adrenergic antagonist into an area near your trachea. This anesthesia will block pain signals normally received by a group of nerve cells called the stellate ganglion. After your injection, you will be monitored to judge the effects of treatment. If your reaction to a nerve block is positive but temporary, your doctor may recommend a surgical technique called a sympathectomy. In this procedure, a surgeon will cut away a section of the sympathetic nerve to suppress its activity in the area causing you pain. Be aware that this surgery is not well-regarded by all RSD specialists, and your symptoms may actually worsen after treatment.

    Additional Options

    • Use of a transcutaneous electrical nerve stimulation (TENS) device may help improve your RSD symptoms. Emotional support, counseling, and advice from a chronic pain center may also prove beneficial.

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