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What is Reflex Sympathetic Dystrophy?

Sympathertic Nerve System

What is RSD?

Reflex Sympathetic Dystrophy or RSD is a type of complex regional pain syndrome or CRPS. It’s a disorder that causes lasting pain, usually in an arm or leg, and it can show up after an injury. The severity of the pain is typically worse than the original injury itself.

RSD is sometimes called Type I CRPS, and it’s caused by injury to tissue with no related nerve damage. For Type II CRPS (otherwise known as CRPS II or Causalgia), click here.

What Causes RSD?

Doctors think that the pain caused by RSD comes from problems in your sympathetic nervous system. That system controls blood flow movement that helps to regulate your heart rate and blood pressure. When you get hurt, your sympathetic nervous system tells your blood vessel to get smaller so you don’t lose too much blood at your injury site. Later, it tells the blood vessels to open back up so blood can get to the damaged tissue to 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 excessive pain and swelling at the injury site. Sometimes, you can get RSD even if you haven’t suffered an injury. RSD can also be the result of infections, radiation therapy, cancer, surgery, heart attack, stroke, or emotional distress, but more often is associated with physical trauma.

What are the Symptoms of RSD?

RSD occurs in the extremities. It most commonly affects the upper limbs, but it’s possible to get it in the lower limbs as well. Specifically, you may experience RSD in your hands, fingers, arms, shoulders, legs, hips, or knees.

Common symptoms can be any of the following:

  • Stiffness

  • Discomfort

  • Pain or burning sensations

  • Swelling

  • Sensitivity to heat or cold

  • Weakness

  • Feeling warm to the touch

  • Skin redness

  • Skin paleness with a blue tone

  • Tenderness

  • Sweating around the affected area

  • Changes to the skin in the affected area

  • Muscle weakness

  • Muscle spasms

  • Muscle atrophy

  • Joint pain and stiffness

  • Nail and hair changes

How is RSD Diagnosed?

Early diagnosis of RSD is important before it gets worse, but there’s not a definitive test for RSD. Rather, your doctor will review your medical history, conduct several tests, and perform a thorough physical examination. The tests could include bone scans, MRI, X rays, nerve conduction studies, or skin temperature readings.

Because some of the symptoms of RSD may be caused not by injury but by other conditions, it may be difficult for your doctor to correctly reach a diagnosis. Conditions such as arthritis, Lupus, Multiple Sclerosis, blood clots, muscle diseases, or small fibre polyneuropathies may produce the same symptoms as RSD. It may take your doctor a considerable amount to time to reach the correct diagnosis, so don’t be discouraged.

How is RSD Treated?

Early detection is very important in treating RSD, so the length of time it takes to diagnose can be troubling. There is no cure for RSD, but it’s possible to recover from some of the symptoms which may go into remission.

Treating chronic pain can be a challenge, and it may take several combinations of treatments to relieve your pain. The goal of treatments for RSD is to relieve your pain and allow you to be able to function in your day-to-day life.

Pain Relievers

You may be able to control the symptoms of RSD at home with pain relievers such as paracetamol, aspirin, or ibuprofen. In severe cases, stronger pain killers such as muscle relaxers, opioids, steroids, or topical anaesthetics may be effective. Medical opinions vary hugely on the most effective treatments.

Physical Therapy

Sometimes, physical therapy can help to rehabilitate an affected limb. This type of therapy will ensure that you continue to move the limb to retain its abilities, muscle tone and flexibility. It also improves your blood flow and reduces symptoms related to circulation problems. Continued physical therapy may be needed to reduce symptoms.


It may also help to see a health professional for counselling, as psychotherapy can help people with RSD. Therapy doesn't stop RSD from happening or affect the symptoms, it can help a person learn how to process and manage feelings so that they're less overwhelming. That can help a person with RSD feel more in control of their emotions and to learn to live alongside their pain.

Alternative Therapies

There are alternative forms of treatment that may be helpful, such as acupuncture, dry needling, hypnosis, yoga or meditation.


RSD, often referred to as CRPS-I, can result is a variety of outcomes. Accurate diagnosis and effective treatment protocols for RSD may require a specially trained neurologist as well as a specialist in pain management. Early intervention and treatment may minimize symptoms and allow the patient to return to a normal life. Alternatively, the symptoms being experienced may get worse or may not be diagnosed in a timely fashion. In these cases, a patient has to learn how best to use the therapies mentioned above to manage their symptoms so that they can live as full a life as possible.

For more information on Complex Regional Pain Syndrome, please visit our CRPS Pain Condition page.

Contact FT Chronic Pain Solicitors today

FT Chronic Pain Solicitors is a law firm dedicated to representing those who suffer from chronic pain as a result of an accident that was the fault of someone else. Our two partners, Anne Felmingham and Paul Turner, have decades of experience in this area of the law, and have over the years, recovered millions of pounds in damages for their clients. We offer sound legal advice, but also work at facilitating information, treatment, and support for those we represent.

If you suffer from chronic pain caused by the negligence of others, we would be happy to offer a free initial consultation. We are a modern law firm which is not constrained by bricks and mortar, so we prefer electronic communication in relation to documents. Contact us today by email, or give us a call to see how we can help you with your personal injury claim.


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