Reflex Sympathetic Dystrophic
Reflex sympathetic dystrophic is a state in where a group of distinct symptoms, including tenderness, pain, inflammation and extreme swelling with changing degrees of sweating, flushing, shiny skin and discoloration. Reflex sympathetic dystrophy is also called as the ‘shoulder-hand syndrome’, ‘complex regional pain syndrome’, ‘Sudeck’s atropy’ and ‘causalgia’.
What are the Causes of Reflex Sympathetic Dystrophy?
The accurate process of the development of RSD is not known properly. The studies include the abnormal excitement of nervous tissue, resulting in abnormal impulses along the nerves that affect skin and blood vessels. The peripheral nerves, involuntary nervous system and brain are also involved.
Various events can cause Reflex sympathetic dystrophy as following:
- Heart disease
- Stroke or other brain diseases
- Degenerative arthritis of neck
- Shoulder problems
- Nerves irritation by entrapment
- Breast cancer
- Drugs for tuberculosis and barbiturates.
Symptoms of RSD:
RSD symptoms will be gradual or rapid. The condition may not show all the features. It is bilateral in up to half of the people with RSD. There are various stages of RSD with the following symptoms:
Acute: Symptoms in the months three to six are burning, sweating, flushing, blanching, tenderness, swelling and pain. This stage shows early X-ray changes of patchy bone thinning.
Dystrophic: In three to six months initial skin changes of thickened, shiny skin and contracture with relentless pain, but very little swelling and flushing.
Atrophic: After long-standing, loss of function and motion of the involved foot or hand with contracture and thinning of fatty layers under the skin occurs. X-rays show significant osteoporosis.
Reflex Sympathetic Dystrophy Treatment:
The response to the treatment of RSD is higher in initial stages than in final stages.
- Moist, cool applications to the affected area can relive from burning symptoms.
- Gentle exercises can help in preventing contractures.
- Medication for inflammation and pain will also reduce symptoms.
- For prevailing symptoms, high doses of cortisone are used for weeks, and then reduce gradually depending on the response.
- Other medications would also benefit including pregabalin, amitriptyline and clonidine.
- At times nerve block with anesthetic injected into a particular area of an involuntary nervous system will help in establishing and treating the diagnosis. Sometimes these blocks are tries in series.
- Other treatments like a surgical interruption in the nerves of an involuntary nervous system, implantation of pumps with pain medication in the spinal canal and spinal cord stimulation devices.
There is some proof that early immobilization of victims with stroke or heart attack helps to decrease the chance of developing RSD. There are theories demonstrating, with daily supplementation of Vitamin C there is a decrease in the risk of developing RSD in the patients with bone fractures.