Reflex Sympathetic Dystrophy Syndrome (Complex Regional Pain Syndrome)

Medically Reviewed by Dr. K on 17 March 2021

What Is Reflex Sympathetic Dystrophy Syndrome?

Reflex sympathetic dystrophy syndrome (RSD) is a disease that induces persistent pain in an arm or leg, typically following an accident, stroke, or heart attack. However, the discomfort is normally more intense than the initial fracture. Doctors aren't sure what triggers it, but they can manage it in most situations.

Doctors no longer refer to the condition as reflex sympathetic dystrophy syndrome. It's an earlier term for one type of Complex Regional Pain Syndrome (CRPS) (CRPS). RSD is also known as Type I CRPS because it is triggered by tissue inflammation without any associated nerve damage.

What Causes RSD?

RSD pain is believed to be triggered by complications in the sympathetic nervous system, according to doctors. Your sympathetic nervous system regulates blood flow and tends to control your heart rate and blood pressure.

When you're injured, the sympathetic nervous system tells your blood vessels to constrict so you don't lose so much blood at the site of the injury. It then instructs them to reopen the wound so that blood can enter the damaged tissue to heal it.

Your sympathetic nervous system receives conflicting messages while you have RSD. After an accident, it shuts on but does not switch off. Which results in a lot of discomfort and swelling at the location of the injuries.

Even if you haven't been hurt, you can develop RSD.

Women are more likely than men to suffer from RSD. It may affect children as well, although it normally appears between the ages of 30 and 60.



When you have RSD, the symptoms can appear gradually. You can experience discomfort at first, which then worsens over time. At first, you do not notice that the discomfort is abnormal.

RSD may be caused by a variety of accidents, including:

  • Amputation
  • Abrasions
  • Bruises
  • Burns
  • Cuts
  • Fractures
  • Surgery
  • Needlestick injuries
  • Radiation therapy
  • Sprains / strains

RSD more often affects the arm, shoulder, leg, or hip. The discomfort usually extends beyond the origin of the accident. Symptoms may travel to other areas of the body in certain situations.

Your immune system may be damaged by RSD. This will lead to:

  • Redness
  • Warm to touch
  • Swelling

RSD is characterized by intense and extreme pain. RSD pain is defined by many people as:

  • Aching
  • Burning
  • Cold
  • Deep
  • Throbbing

Your skin can even become sensitive to situations that usually don't affect it, such as having a shower. It might even be painful to simply put on your clothing.

Some RSD signs include:

  • Changes in your hair or nail growth, as well as the feel of your skin
  • Sweating excessively in some parts of the body
  • Muscle spasms or fatigue
  • Joints that are stiff
  • Difficulty moving the injured area.
  • Skin that is white, mottled, red, or blue.


Often, doctors don't realize RSD is causing the discomfort until you've had it for a while. When discomfort persists or is more intense than it should be with your type of injury, it may be the first sign of RSD.

There is no single test that will determine whether or not you have RSD. Instead, they'll rely on a medical history and a physical examination. There are a few tests that will help you determine out if you have certain symptoms of the disease. There are some of them:

Bone scan
This test will reveal whether some of the bones are wearing down at the ends or whether there are any problems with blood flow.

An MRI might be requested by your doctor to evaluate the inside of your body, especially your tissues, for any noticeable differences.

Sweat test
If you sweat more on one side of your body than the other, this test will indicate it.

Thermography test
This sympathetic nervous system examination measures if the temperature or blood pressure at the accident site varies from the rest of the body.

This is usually ordered after the condition has progressed to the point that you need to check for mineral deficiency in your bones.



Early diagnosis and management of RSD are vital. The quicker you recognize it, the more successful your treatment would be. RSD does not often respond to medication. While there is no treatment for RSD, many of the effects may be alleviated.

The following are some of the medicines that your doctor can recommend:

  • Anesthetic creams – lidocaine
  • Antidepressants
  • Anti-inflammatory drugs – non-steroidal anti-inflammatory drugs
  • Anti-seizure medications
  • Nasal spray that treats bone loss
  • Nerve blocking injections
  • Over-the-counter medications like aspirin, ibuprofen, or naproxen for pain relief

Other treatments that are not often used due to the possibility of negative side effects and a lack of evidence that they work include:

  • Corticosteroids like methylprednisolone or prednisolone to treat swelling
  • Opioids, such as fentanyl, hydrocodone, morphine, and oxycodone

Symptoms may also be treated in the following ways:

  • Small electric shocks are delivered by electrodes on the spinal cord to alleviate discomfort.
  • Physical therapy can assist you in moving around more quickly and relieve discomfort.
  • Relaxation strategies can be taught by psychotherapy.
  • Hand splints are used to alleviate discomfort in the hands.

If the pain doesn't seem to be going away after medication, your doctor may recommend a sympathectomy operation. A surgeon cuts those nerves around the blood vessels during this operation to further increase blood supply.


Referenced on 2.3.2021:

  1. Medscape: “Reflex Sympathetic Dystrophy.”
  2. Mayo Clinic: “Complex regional pain syndrome.”
  3. National Institute of Neurological Disorders and Stroke: “Complex Regional Pain Syndrome Fact Sheet.”
  4. RSDSA: “Telltale Signs and Symptoms of CRPS/RSD.”
  5. National Organization for Rare Disorders: “Reflex Sympathetic Dystrophy Syndrome.”
  6. New York State Department of Health: “Reflex Sympathetic Dystrophy Syndrome.”

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