(RSDS/CRPS)
Your body functions under the control of your nervous system. Nerves act like wires in a car, and the brain acts like the engine. When you press on the gas pedal, there are wires that send information from the pedal to the engine telling the engine you want the car to move. There is another set of wires that start in the engine and send information to the tires telling the tires to move. Likewise,your body has two sets of nerves, or "wires." One set connects your muscles and organs to your brain, and the other set connects your brain to your muscles and organs. In RSDS, damage to either one of these nerve connections can cause the burning pain, swelling, and other common signs and symptoms to be discussed shortly. For reasons unknown, the nerves start functioning inappropriatly for a varying length of time.
Damage to a nerve can result from a wide range of injuries, including sports injuries, car accidents, broken bones, spine disorders, heart attacks, surgery, infections, or even a splinter in the finger. In some cases, the preceeding injury remains unidentified. The injury usually involves trauma to an extremity, such as an arm or a leg.
Pain -- The RSDS patient often first notices a severe, constant, burning or deep aching pain in one or more of the extremities. The pain experienced by the patient is often out of proportion to that expected by the initial injury.
Skin Changes -- The skin of the affected extremity may become shiny, dry, scaly, sweaty, or goose fleshy. The skin color can range from white to red to blue. The nails of the affected extremity may begin to grow faster than the unaffected limb. The affected limb may feel warm or cool to touch.
Swelling -- The swelling is usually widely spread over the painful region, and may sharply follow a demarcating line over the surface of the skin.
Movement Disorder -- Patients may notice joint stiffness, difficulty moving, tremors, involuntary jerking, and muscle spasms and cramps of the affected extremity.
Spreading -- The previously mentioned changes usually begin and remain localized to the injured extremity. After some time however, the symptoms may begin to spread to other regions of the body. Spreading makes treatment more difficult.
Bone Changes -- The bones may begin to waste away or demineralize, as noted on X-ray.
Click here for a photo gallery of the skin, swelling, and extremity changes. Please note, RSD patients may or may not present with these physical findings, or they may present with varying degrees of severity. As always, it is best to consult with a physician if you suspect you or someone you know has RSDS.
The diagnosis of RSDS is based on the patient's clinical presentation including history of trauma and other associated physicial findings as mentioned under "Signs and Symptoms". Unfortunately, there is no single test that can prove the diagnosis of RSDS. However, evidence for or against the diagnosis of RSDS may be gained through various tests including: a thermogram ( a noninvasive test measuring heat emission from the skin), a sympathetic block (a temporary block of the affected nerves' ability to transmit a signal to see if this decreases the patient's pain), X-ray, nerve conduction studies, CAT scan, and MRI studies. Because early diagnosis and treatment are key to prevent spreading and to improve the patient's quality of life, it is important for a person to consult a doctor if he or she suffers from the above mentioned symptoms.
RSDS does not appear to alter the patient's life span, but if left untreated the patient may experience significant physical disabilities and decreased quality of life. These disabilities include muscle wasting due to disuse of the stiff, painful extremity, diffuse osteoporosis from spreading of the localized bone destruction, and worsening, untreatable pain. These physical disabilities eventually become irreversible if left untreated.
Treatment begins with education. The patient must be aware of his of her treatment goals, and encouraged to use the affected limb through its normal range of motion. Treatment options include medications, physical and occupational therapy, temporary or permanent nerve blocks, psychosocial therapy, and spinal cord stimulation. For more information on these and other treatment options, please refer to the RSD hope treatment page.
RSDS Association of America (www.rsds.org)
RSD Coalition (www.rsdcoalition.com)
RSD Hope (www.rsdhope.org)
RSD Spouse Support Network (www.rsdspouse.net)
