[Daniel M]

What is reflex sympathetic dystrophy?

[meey]

it is a chronic progressive disease that characterized by severe pain, swelling and changes in skin where the exact cause is unknown.it can be precipitated by illness, injury or surgery.it normally occurs near the site of injury and spread beyond the original area. the most common symptoms are burning pain,muscle spasm, local swelling, increased sweating, joint tenderness and stiffness, restricted and painful movement and changes in the skin and nails.

[Loz]

RSD is actually now known as Complex Regional Pain Syndrome (CRPS), because the role of the sympathetic nervous system appears to be less important than was once thought.It is usually the result of some sort of trauma, be it injury or surgery, minor or severe. The current theories out there seem to suggest that it is partly due to a process called'central sensitisation'and'wind up'. It's very difficult to try to explain, but in'simple'terms - pain signals to the central nervous system (CNS) sensitise certain nerves and receptors to those signals ('wind up'). The line of thought with CRPS is that the CNS becomes more and more sensitised to those signals, setting up a vicious cycle of abnormal pain signals ('central sensitisation'). The role of the sympathetic nervous system, while still recognised, is now thought to be less important than it once was. Some people do experience'sympathetically maintained pain'(SMP - which is responsive to treatments such as sympathetic nerve blocks), but in others it is classed at'sympathetically independent pain'(SIP - more common in longer-standing CRPS cases). Many of the visible changes associated with CRPS do appear to be autonomic in origin.In practical terms, it is a chronic neuropathic pain disorder. It causes severe, unremitting pain and trophic changes (skin, hair and nail growth) as well as oedema and colour&temperature fluctuations. In some cases there can be other complications, such as muscle dystonia, ulceration, etc.The treatments are pretty varied, but include sympathetic nerve blocks, antidepressants&anticonvulsants (both of which have activity against neuropathic pain), other drugs, physiotherapy (VERY important!), ketamine infusions, spinal cord stimulation, intrathecal medication, and the list goes on.I've had CRPS for 9 1/2 years. Have been through all of the above treatments and am now in a wheelchair due to severe involvement of both my legs.