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WHAT IS REFLEX SYMPATHETIC DYSTROPHY (RSD)?

Written by pharmacist  |  15. December 2001

Dear Viewers:
I have been receiving many request for articles relating to different types of pain and the treatment for such pain. Since I am actively involved in the preparation of pain medication tailor-made for patients at Pain Care of Long Island, under the medical direction of Dr. Harvey Finkelstein, I will offer the next three articles to pain management...SF

Reflex Sympathetic Dystrophy is a chronic pain disorder involving the sympathetic nervous system. It usually is the result of an injury or trauma, but can also be a complication of surgery, infection, casting or splinting and myocardial infraction (heart attack). The trauma sets off the body's mechanism for pain recognition, but then the "normal system of pain perception" begins to misfire in it neural response, and an abnormal cycle of intractable pain begins. As RSD progresses, the abnormal pain of the sympathetic nervous system has an effect on other areas of the body and can result in total disability as muscles, bones, skin and the autonomic immune system become involved. The first indication of RSD is prolonged pain usually more severe than the injury. The symptoms are severe burning pain in a localized area, intense sensitivity to temperature and light touch, and a color change to the skin. There are several stages to RSD, which progress at different rates in different people. Initially, there is swelling and redness in the affected area. Next, the area becomes blue and cold, with increased pain and stiffness of ligaments and joints, and Osteoporosis may become evident. Finally, there may be a wasting of affected muscles, contraction of tendons, and a definite withering of the affected limb. In all of the stages, severe chronic pain continues to be a major complaint. Although RSD can be a progressive disorder, it should not be assumed that all cases will advance and present all clinical symptoms and dysfunction. CLINICAL SYMPTOMS OF RSD Pain is the first and primary complaint, described as extremely severe and burning & aching in nature Swelling and joint tenderness Loss or diminished motor function Muscle spasms Increased sweating Changes in skin temperature and color Bone softening - patchy osteoporosis Trauma (often minor) such as a bruise, sprain or broken bone Surgery Myocardial Infarction ( heart attack ) Infections Repetitive motion disorders such as Carpal Tunnel Syndrome HOW IS RSD DIAGNOSED? Clinical Evaluation Sympathetic Blockade X-Ray Thermographic Study EMG, CAT scan, MRI studies IV Systemic Blockade HOW IS RSD TREATED? Drug Therapy Nerve Blocks Physical Therapy Sympathectomy Transcutaneous Electrical Stimulator IMPLANTABLE DEVICES: Spinal Cord Stimulator or Drug Delivery Infusion Pump. For more information about the treatments and referral to a qualified Pain Management Center for RSD...E-mail me at Sferzola@hotmail.com

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