Clinical Features Of RSD
Although the incidence of RSD / CRPS is unknown, RSD is not a rare problem. The condition is believed to occur primarily in females with a predominance of 2:1 to 3:1 over males. Although the disease may be caused by major trauma, it often results from an injury that is minimal in nature or even unknown. In approximately 1/3 of patients, no known cause or trauma can be identified. Risk factors for the development of RSD / CRPS include immobilization, smoking, genetics, and psychological factors.
Pain is the initial manifestation of RSD and typically occurs within several weeks after the injury. Characteristically, the pain is severe and progressive, spreading throughout the affected extremity. The pain distribution is typically widespread and does not fit a specific nerve pattern. Because of the non-specific pain distribution and the degree of pain being so out of proportion to the injury, patients with Reflex Sympathetic Dystrophy are often given erroneous diagnoses of hysteria or malingering. This is especially true when the patient has a worker’s compensation or personal injury lawsuit that has arisen out of the original injury.
> Diagnosis of Reflex Sympathetic Dystrophy (RSD)
The pain involved with RSD / CRPS is typically described as a burning, aching, or throbbing pain and is typically worsened by exposure to cold weather or water. The affected region often undergoes changes in temperature, coloration, and nail formation if the affected region involves the hands or feet. In addition to the abnormalities in the appearance of the affected limb, the function of the involved extremity is affected by both pain and motor dysfunction.
There is often sensory abnormalities, reduced range of motion, edema (tissue swelling), and excessive sweating in the affected limb. Several different types of movement disturbances can occur including problems initiating movement, weakness, and muscle spasms. In addition, more dramatic movement disorders such as tremors and distonia (prolonged contraction of the extremity) may also occur.
The combination of unrelenting pain, physical impairment, spasm, and motor dysfunction can cause serious impairment of a patient’s personal, social, emotional, and work lives. The unrelenting pain may not respond to medical treatment and can lead to family disruption, job loss, and a severely diminished quality of life. Combining these factors with physician disbelief or an erroneous diagnosis of malingering can be catastrophic to the patient.
