Information From Your Health Care Provider

REFLEX SYMPATHETIC DYSTROPHY SYNDROME

Basic information

description

Reflex sympathetic dystrophy syndrome is a chronic disorder that affects the arms or legs, and rarely, other parts of the body. It involves the nerves, skin, muscles, blood vessels, and bones. Symptoms vary in severity and how long they last. It can occur at any age, including children. It is more common in ages 30 to 60.

FREQUENT SIGNS & SYMPTOMS

Pain (may be burning or aching) and swelling. These symptoms may increase over time.
Skin changes. Color changes from pale to purple/blue or gray. Affected area may be tender, thin, and shiny.
Hair and nail growth is increased. These symptoms may decrease with time.
Stiff joints and muscle spasms.
Excessive sweating.
Extreme sensitivity to touch.

causes

The exact cause is unknown. The pain that occurs is more severe than would be expected from an injury. The sympathetic nervous system that controls blood flow and sweat glands appears to play a role in the cause.

risk increases with

Genetic factors may increase the risk.
A tendency toward increased sympathetic activity. This includes cold hands, excessive sweating, or a history of fainting.
Major or minor injury to an arm or leg.
Heart attack, stroke, pancreatic cancer, herpes zoster, arthritis, nerve compression disorder, and others.
Chest, neck, or shoulder injury.
The period following surgery.
Prolonged time in a cast or splint.

PREVENTIVE MEASURES

None specific. Avoid risk factors where possible. If injured, begin physical therapy or exercise therapy as soon as possible.

expected outcomes

Outcome will vary in different people. Some may be helped with treatment, some cases clear up on their own, and others have ongoing pain despite treatment.

possible complications

Disabling pain that may affect an entire arm or leg.
Muscle wasting (atrophy) and severe joint damage.
Skin damage that cannot be reversed.
Tightening of the muscles as they lose their tone. Hand and fingers or foot and toes may contract into a fixed position.
Depression and anxiety due to chronic pain.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms, activities, and medical history. This is often enough for diagnosis. An x-ray or bone scan or other tests may be done.
There is no cure, but there are treatment options. These include drugs, counseling, physical therapy, splinting, surgery, spinal cord stimulation, implanted drug pumps, and others. Your health care provider will devise a treatment plan based on your symptoms.
TENS (transcutaneous electrical stimulation) may be recommended. It uses brief pulses of electricity applied to nerve endings under the skin to relieve pain.
Applying cold may relieve swelling and sweating. If the affected area is cool, applying heat may offer relief.
Massage therapy will help some people.
Biofeedback may help. It is a technique that involves learning to become more aware of your body to help you relax and to relieve painful symptoms.
Counseling may help you learn ways to cope with the chronic pain. Joining a support group may also help.
To learn more: Reflex Sympathetic Dystrophy Syndrome Association website: www.rsds.org.

medications

You may take nonprescription drugs for pain and inflammation such as ibuprofen or naproxen.
Steroids to reduce swelling and inflammation, drugs that widen blood vessels, injections of local anesthetic, stronger pain drugs, or other drugs may be prescribed.

activity

Maintain normal daily activities as best you can.
Physical therapy may be prescribed to help keep muscles flexible, strong, and mobile. Occupational therapy (e.g., for the hands) can help with activities of daily life.