FAQ’s on Reflex Sympathetic Dystrophy (RSD) & Complex Regional Pain Syndrome in Dallas/Fort Worth
What are Reflex Sympathetic Dystrophy (RSD) & Complex Regional Pain Syndrome (CRPS)?
Both Reflex Sympathetic Dystrophy (RSD) and Complex Regional Pain Syndrome (CRPS) are conditions of chronic pain localized to one or more areas of the body. Patients most often experience both RSD and CRPS in a single limb after a period of trauma has occurred or following a direct nerve injury to the limb.
As RSD and CRPS are a potential result of limb injury, they can occur at any age. It is more common to see these conditions manifest in women over the age of 40, and are rare to find to children and the elderly but can still occur.
What causes Reflex Sympathetic Dystrophy (RSD) & Complex Regional Pain Syndrome (CRPS)?
Physicians are still trying to determine the exact causes of RSD and CRPS in patients, as the exact event that triggers these conditions will vary in patients. It is also possible for one patient to develop symptoms of pain while another patient with the same stimuli does not react.
The separate conditions are known as CRPS I and II. Reflex Sympathetic Dystrophy is diagnosed as CRPS I. With CRPS I, a patient will have chronic pain without the confirmation of nerve damage as a cause. CRPS II, which is Complex Regional Pain Syndrome, on the other hand is the presence of chronic pain with confirmed nerve damage.
Both CRPS I and II are potential results from direct injury to a limb, including fracture, immobilization of the limb, severe sprain, or as a potential result of surgery. CRPS can be thought of in terms of an allergic reaction to injury: some patients may experience severe negative effects while others do not.
The symptoms of Reflex Sympathetic Dystrophy (RSD) & Complex Regional Pain Syndrome (CRPS)
Symptoms are shared between CRPS I and II, with the primary symptom of pain occurring in an extended duration of time and isolated to limb. Sensations of pain can vary, ranging from debilitating occurrences to minor annoyances. Nerve damage in the limb may also potentially affect the circulatory functions in the area, producing fluctuations in temperature and color of the skin.
Some patients may lose a portion –or all- of their control over the affected muscle groups of the limb. This may also present itself as involuntary muscle spasms, creating a jerking movement. Circulatory irregularities may also cause excessive sweating in the area.
How is Reflex Sympathetic Dystrophy (RSD) & Complex Regional Pain Syndrome (CRPS) diagnosed?
A single diagnostic test that can accurately diagnosis the presence of either RSD or CRPS in a patient has yet to be developed. Instead, diagnosis is achieved through a culmination of the medical history of the patient, the severity of the present symptoms, and the number of symptoms present that match the accepted symptoms of the accepted definitions of RSD and CRPS.
Physicians have a list of what symptoms, and what degree the symptoms must be present, that has to be fully or partially matched in order for diagnosis to be achieved. Many patients will receive diagnosis as a process of elimination. This is due to the wide variety of conditions that can produce similar symptoms to RSD and CRPS that must first be tested for in order to rule them out as causes.
Treatment options for Reflex Sympathetic Dystrophy (RSD) & Complex Regional Pain Syndrome (CRPS)
Patients have a large number of treatment options open for them. These include a combination of medications to help provide relief for their unique symptoms, physical therapy to help strength the limb and correct some degree of circulatory complications, and nerve blocks among others to help with the pain.
Here is a list of treatment options available:
- Medications – NSAIDS, Opiates, Lyrica, Neurontin, Antidepressants, Calcium Channel Blockers and more.
- Physical Therapy
- TENS Unit
- Behavioral Therapy
- Lumbar Sympathetic Blocks
- Stellate Ganglion Blocks
- Surgical Sympathectomy
- Spinal Cord Stimulator
Treatment outcomes are typically directly associated with time frame. The earlier treatment is sought, the better the outcome.
The largest study to date evaluating outcomes with RSD/CRPS showed that if therapy was started in the first couple years of onset the successful results were eighty percent. As the time span lengthened past 2 years, outcomes worsened significantly (Poplawski et al, JBJS, 1983). Between the time frames of two and five years, the success goes down to 70%, and after that it’s really low at 10-20% success.