What is Reflex Sympathetic Dystrophy (RSD)?
According to MedicineNet, RSD involves “irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin.” This basically means that RSD occurs when the part of the unconscious nervous system that controls sweat glands and blood flow in the extremities is disturbed and becomes overactive. Burning pain, swelling, stiffness and discolouration develop in the affected area.
There are any number of possible causes for RSD, but most cases are brought on by injury. Even minor injuries can be responsible, but the pain tends to be greater than you would expect from that type of injury.
Who can develop RSD?
Statistically, women are more likely to develop RDS than men, but the condition affects people of any age, including children.
What are the symptoms of RSD?
RSD usually affects one of the extremities (arms, legs, hands, or feet). The primary symptom of RSD is intense, continuous pain, but the symptoms can include: burning pain; increased skin sensitivity; skin temperature changes; blotchy, purple, pale or red skin; changes to skin texture to become shiny, thin, sweaty; changes to nail and hair growth; stiffness and swelling in the affected joints; decreased mobility of the affected extremity.
Pain can spread to a wider area and even to the opposite extremity.
The stages of development of RSD
Some experts suggest that RSD develops in three stages.
The initial stage can last several months and causes pain (often described as burning), and excess sweating in the affected part of the limb, which also becomes warm and red. During this stage, someone with RSD may notice their hair and nails grow faster than usual. The joints of the affected limb may become painful.
Stage two can last up to a year and is known as the dystrophic stage. During this, the affected limb may be constantly swollen, causing wrinkles in the skin to disappear. Fingernails become brittle, and the pain and stiffness spread up the limb and along the same side of the body, or may spread to the opposite limb.
After a year, RSD enters stage three – the atrophic stage. The muscles may waste away and the skin usually becomes stretched, shiny and pale. The pain may lessen but is constant, and the part of the body affected is stiff. The skin may also be hypersensitive to touch. Once this stage has been reached, the chance of recovering movement diminishes.
How is RSD treated?
If identified early, RSD can be treatable.
Treatment is aimed at controlling pain, enabling the person to regain or improve the function of the affected limb, and providing emotional support.
Nerve blocks are most effective – these are injections of local anaesthetic into the affected nerve.
Medication may also be used to relieve symptoms, including painkillers and drugs such as amitriptyline, which is most commonly used to treat depression but can treat nerve pain too.
Other drugs that may be prescribed include gabapentin (a drug used to treat neuropathic pain) and oral steroid medication.
Physiotherapy is important to help regain function and relieve symptoms. Occupational therapy can help someone learn how to overcome the difficulties they’re facing with everyday activities.