Reflex Sympathetic Dystrophy is a chronic pain disorder involving the sympathetic nervous system. It usually is the result of an injury or trauma, but can also be a complication of surgery, infection, casting or splinting and myocardial infarction (heart attack). The trauma sets off the body's mechanism for pain recognition, but then the "normal system of pain perception" begins to misfire in its neural response, and an abnormal cycle of intractable pain begins. As RSD progresses, the abnormal pain of the sympathetic nervous system has an effect on other areas of the body and can result in total disability as muscles, bones, skin and the autonomic immune system become involved.

The first indication of RSD is prolonged pain usually more severe than the injury. The symptoms are severe burning pain in a localized area, intense sensitivity to temperature and light touch, and a color change to the skin.

Most physicians agree that there are three stages to RSD, which progress at different rates in different people. Initially, there is swelling and redness in the affected area. Next, the area may become blue and cold, with increased pain and stiffness of ligaments and joints, and Osteoporosis may become evident. Finally, there may be a wasting of affected muscles, contraction of tendons, and a definite withering of the affected limb. In all of the stages, severe chronic pain continues to be a major complaint.

clinical Symptoms of RSD

• Pain is the first and primary complaint, described as extremely severe and
  burning and aching in nature
• Swelling and joint tenderness
• Loss or diminished motor function
• Muscle spasms and tremors
• Increased sweating at injured area
• Changes in skin temperature and color
• Bone softening - patchy osteoporosis

What Causes RSD?

• Trauma (often minor) such as a bruise, sprain, broken bone, tight fitting cast
• Surgery
• Myocardial Infarction ( heart attack )
• Infections
• Repetitive motion disorders such as Carpal Tunnel Syndrome

How is RSD Diagnosed?

• clinical Evaluation
• Sympathetic Blockade
• IV Systemic Blockade
• Thermographic Study
• Discograms, Angiograms, Bone Scans
• Nerve Conduction Studies

How is RSD Treated?

• Drug Therapy
• Nerve Blocks
• Physical Therapy
• Transcutaneous Electrical Stimulator

Implantable devices:

• Spinal Cord Stimulator
• Drug Delivery Infusion Pump
• Sympathectomy indicated in some cases

When one clearly understands pain;
when one absolutely knows
the proper treatment, then one can offer to any patient
personal pain management that works.
This is my specialization.

-Lynne Carr Columbus, D.O.