Sympathetic Reflex Sympathetic Dystrophy

What is reflex sympathetic dystrophy?

Reflex sympathetic dystrophy or RSD is a disease that involves a disruption in the sympathetic nervous system. In this case, it is a picture of intense and chronic pain, lasting more than six months, with stiffness and color changes in the skin tone in the affected areas.

The nerves affected by reflex sympathetic dystrophy are those located on both sides of the spinal cord and are responsible for controlling some bodily functions, such as opening and closing blood vessels.

As a general rule, reflex sympathetic dystrophy affects the hands and feet, although it can also affect the arms and legs.

RSD or reflex sympathetic dystrophy is also known as reflex sympathetic dystrophy, Sudeck’s atrophy, complex regional pain syndrome, reflex neurovascular dystrophy, causalgia or shoulder girdle syndrome.

Prognosis of reflex sympathetic dystrophy

Outcomes are highly variable. In young people the results are usually better, although positive results can also be achieved at older ages. In other cases, despite treatment, the affected person will suffer pain and disability.

If treatment is started early, the disorder can be limited, although more information on the development of the disease is needed.

Symptoms of reflex sympathetic dystrophy

The most important and definitive symptom of reflex sympathetic dystrophy is prolonged and severe pain, which can become constant, thus impeding the sufferer’s life and rest. DRS is sometimes described as a sensation of pressure, tingling or even burning in the affected condition.

Although it usually affects only one limb, this pain may spread to the opposite limb or extend along the length of the limb.

Under normal conditions, the affected area is an area that is particularly sensitive to pain, with contact with the skin being extremely painful. This is known as allodynia.

In turn, those affected by this disease may also suffer changes in their temperature, along with the color of the skin.

The main symptoms are:

– Prolonged pain

– Changes in the texture of the skin in the affected area.

– Excessive sweating in the area

– Stiffness and difficulty moving the affected joints

– Muscle coordination problems

– Muscle pain

– Changes in the color of the skin, which may turn from red or blue to blotchy

Medical tests for reflex sympathetic dystrophy

There is no medical test that diagnoses this disease. Diagnosis is based on medical history as well as signs of the disease. The diagnosis becomes more complicated as the disorder progresses.

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The main characteristic of this problem is that there is a lesion in the affected area. An MRI or scan may be requested to confirm the diagnosis.

The affected area is particularly sensitive to pain.

Causes of reflex sympathetic dystrophy

Although the origin of this disease is still unknown, it is known that in a very high percentage of cases, the syndrome appears due to a history of injury, the most common being the following:

– Fractures

– Injuries in soft tissues, such as burns or blows.

– Sprains and/or strains

– Immobilization of the extremity

In this case, the disease is an abnormal response of the organism, which amplifies the effects of the injury or trauma. It could be compared to an allergic reaction, in which some people overreact while in others it causes no problems.

Blood vessels in the limb may dilate and leak fluid into the tissue, causing the skin to redden and swell. Nearby muscles may be starved of oxygen, contracting or tightening.

Can dystrophy be prevented?

This disease is still under investigation. From what is known about it so far, the only way to avoid or prevent it is to try to avoid an injury that causes it.

Treatment of complex regional pain syndrome

The treatment of this pathology often uses the following treatments:

– Rehabilitation and physical therapy: exercise routine that mainly keeps the affected area moving. Blood flow is improved and circulatory symptoms are reduced.

– Psychotherapy: this disease often causes profound psychological effects, such as anxiety, depression or post-traumatic stress.

– Medications: Some medications are effective in treating the disease.

– Sympathetic nerve block: several cases have been reported of patients reporting pain relief.

– Surgical sympathectomy: this is an intervention that destroys some nerves, although its use is controversial.

– Spinal cord stimulation: electrodes are placed on the spine, although minor surgery is required to install everything.

– Neurostimulation: applied to the area of discomfort or where the pain occurs.

– Intrathecal drug infusion pump: medication is pumped to relieve pain, although there is no evidence that it improves RSD.

Which specialist treats reflex sympathetic dystrophy?

The specialists in charge of treating and investigating RSD are the experts in Anesthesiology and Pain Unit.