Reflex Sympathetic Dystrophy Syndrome



What is reflex sympathetic dystrophy syndrome?

Reflex sympathetic dystrophy (RSD) is a condition that features a group of typical symptoms, including pain (often “burning” type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin. RSD is also referred to as “complex regional pain syndrome,” “the shoulder-hand syndrome,” “causalgia,” and “Sudeck’s atrophy.”

How common is reflex sympathetic dystrophy syndrome?

Reflex sympathetic dystrophy syndrome is quite rare. It can occur at any age but is most common between the ages of 40 and 60. It occurs slightly more often among females than among males. It has been reported in children and young adults. Please discuss with your doctor for further information.


What are the symptoms of reflex sympathetic dystrophy syndrome?

The onset of RSD symptoms may be rapid or gradual. The condition may not display all features. It is bilateral (involving both sides of the body) in up to half of people with RSD. There are several stages of RSD with symptoms that include:

  • Acute (three to six months): burning, flushing, blanching, sweating, swelling, pain, and tenderness. This stage can show early X-ray changes of patchy bone thinning.
  • Dystrophic (three to six months): early skin changes of shiny, thickened skin and contracture with persistent pain, but diminished swelling and flushing.
  • Atrophic (may be long-standing): loss of motion and function of the involved hand or foot with contracture (flexed scarring process), and thinning of the fatty layers under the skin. X-ray can show significant osteoporosis.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes reflex sympathetic dystrophy syndrome?

Doctors think the pain caused by RSD comes from problems in your sympathetic nervous system. Your sympathetic nervous system controls blood flow movements that help regulate your heart rate and blood pressure.

When you get hurt, your sympathetic nervous system tells your blood vessels to get smaller so you don’t lose too much blood at your injury site. Later, it tells them to open back up so blood can get to damaged tissue and repair it.

When you have RSD, your sympathetic nervous system gets mixed signals. It turns on after an injury, but doesn’t turn back off. This causes a lot of pain and swelling at your injury site.

Sometimes, you can get RSD even if you haven’t had an injury, although it’s not as common.

Risk factors

What increases my risk for reflex sympathetic dystrophy syndrome?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is reflex sympathetic dystrophy syndrome diagnosed?

Often, doctors don’t know your pain is being caused by RSD until you’ve had it for some time. When pain doesn’t go away, or is more severe than it should be for your type of injury, it can be the first clue that it could be RSD.

There’s no single test that can tell your doctor whether you have RSD. Instead, she’ll rely on a physical exam and your medical history information. There are also a few tests that can provide clues to see if you have certain signs of the condition. These include:

  • Bone scan. This test can detect if any of your bones are wearing away at the ends or whether there are issues with regular blood flow.
  • Your doctor might order an MRI to look inside your body, specifically at your tissues, for noticeable changes.
  • Sweat test. This test can tell your doctor if you sweat more on one side of your body than the other.
  • Thermography test. This sympathetic nervous system test checks to see if the temperature or blood flow is different at your injury site than in other parts of your body.
  • X-rays. These are typically ordered if your syndrome is in later stages to look for mineral loss in your bones.

How is reflex sympathetic dystrophy syndrome treated?

Early detection is key in RSD treatment. The earlier you’re able to catch it, the better your treatment will work. Some cases of RSD don’t respond to treatment. RSD doesn’t have a cure, but it’s possible to recover from many of the symptoms.

Some of the medications your doctor may suggest include:

  • Anesthetic creams like lidocaine
  • Antidepressants
  • Anti-inflammatory drugs, called NSAIDs
  • Anti-seizure medications that may help treat pain
  • Corticosteroids like methylprednisolone (Medrol) or prednisolone (AsmalPred Plus) to treat swelling
  • Nasal spray that treats bone loss
  • Nerve blocking injections
  • Opioids, such as oxycodone (OxyContin), morphine (Avinza), hydrocodone (Hysingla ER), and fentanyl (Sublimaze)
  • Over-the-counter options like aspirin, ibuprofen, or naproxen for pain

Other ways to treat symptoms include:

  • Electrodes on your spinal cord that send small electric shocks to relieve pain
  • Physical therapy to help you move around more easily and take away pain
  • Psychotherapy that can teach you relaxation methods
  • Splints to help with hand pain

If your pain doesn’t seem to be going away, even after treatment, your doctor may suggest a surgery called a sympathectomy. During this procedure, a surgeon removes certain nerves around your blood vessels to help improve your blood flow.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage reflex sympathetic dystrophy syndrome?

The following lifestyles and home remedies might help you cope with reflex sympathetic dystrophy syndrome:

  • Cool, moist applications to the affected areas can provide some relief of burning symptoms.
  • Gradual exercise can help prevent contractures.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: August 26, 2018 | Last Modified: August 26, 2018