Health Information

RSD/CRPS DEFINED

Reflex Sympathetic Dystrophy (RSD)/Complex Regional Pain Syndrome (CRPS) is a chronic neurological syndrome characterized by:

  • severe burning pain
  • pathological changes in bone and skin
  • excessive sweating
  • tissue swelling
  • extreme sensitivity to touch
[For a complete description of RSD/CRPS, please read the Diagnosis Section of the Clinical Practice Guidelines of the RSDSA website.]
 
THERE ARE TWO TYPES OF RSD/CRPS--TYPE I AND TYPE II
  • RSD/CRPS Type I (referred to as RSD) includes cases in which the nerve injury cannot immediately be identified because it is a "nerve twig" injury. (This "nerve twig" injury may show up on magnetic neurography.)
  • RSD/CRPS Type II (referred to as Causalgia) includes cases in which a distinct "major" nerve injury has occurred.
  • RSD/CRPS is best described in terms of injury to nerve or soft tissue (e.g., broken bone) that does not follow the normal, anticipated healing path.
  • RSD/CRPS does not depend on the magnitude of the injury.  (Patients and physicians may be surprised by the magnitude of RSD/CRPS symptoms from a "seemingly" minor injury.)  The sympathetic nervous system seems to assume--take on--an abnormal function after an injury.
  • Since there is no single laboratory to diagnose RSD/CRPS, the physician must assess and document both subjective complaints (medical history) and, if present, objective findings (physical examination).
 
CRITERIA FOR DIAGNOSING
RSD/CRPS Type I (RSD)
  • The presence of an initiating noxious event, or a cause of immobilization
  • Continuing pain, allodynia, or hyperalgesia with which the pain is disproportionate to any inciting event
  • Evidence at some time of edema, changes in skin blood flow (skin color changes, skin temperature changes more than 1.1 degree Celsisus difference from the homologous body part), or abnormal sudomotor activity in the region of the pain
  • The diagnosis is excluded by the existence of conditions that would otherwise account for the degree of pain and dysfunction.
RSD/CRPS Type II (Causalgia)
  • The presence of continuing pain, allodynia, or hyperalgesia after a neve injury, not necessarily limited to the distribution of the injured nerve.
  • Evidence at some time of edema, changes in skin bloood flow (skin color changes, skin temperature changes more than 1.1 Celsius degree difference from the homologous body part), or abnormal sudomotor activity in the region of the pain
  • This diagnosis is excluded by the existence of conditions that would otherwise account fo the degree of pain and dysfunction.
 
A BASIC APPROACH TO ADDRESSING SUSPECTED RSD/CRPS:
  1. If you suspect RSD/CRPS, immediately find a physician who SPECIALIZES in this neurological condition.
  2. Advocate for--make an--immediate appointment.  (Time is of the essence because early diagnosis and treatment often secures better outcomes.)
  3. Gather pertinent treatment & laboratory records in addition to x-rays and scans.  Include information about the prescipitating event(s).
  4. Begin familiarizing yourself with RSD/CRPS information.
  5. Prepare a written list of observations about your injury/ies and their accompanying sensations.  Also prepare written question for the specialist during your upcoming appointment.
 

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