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Reflex Sympathetic Dystrophy (RSD) AKA, Complex Regional Pain Syndrome

11/1/2004

Reflex Sympathetic Dystrophy (RSD) AKA, Complex Regional Pain Syndrome  
 
Pain is something that we all experience at one time or another.  Although we seek relief using whatever is available, frequently we find that nothing really works effectively.  Pain management specialists like those at the Pain Management Department at the Cleveland Clinic Foundation devote their careers to figuring out ways and means to help us.  With locations throughout greater Cleveland, the Cleveland Clinic Foundation pain management specialists offer various pain treatment options to these communities.  
 
Although pain is characterized in many ways, some diagnoses are not so obvious.  One such diagnosis is complex regional pain syndrome (CRPS) formerly called reflex sympathetic dystrophy or RSD for short.  This is a disease that is characterized by varying degrees of pain and autonomic disturbances that are reflected in changes of the skin, temperature, color and swelling.  Other trophic changes affecting the skin, hair and nail growth also occur beneath the skin and interfere with function of the muscles, joints and bones.  While all of these may not be present at one time, their overall effect is to interfere with the recovery of function and treatment.  While this disease usually develops after an injury or surgical trauma to the limbs, the name RSD was changed to reflect a better understanding of the painful disorder and to prevent inappropriate treatment directed to the sympathetic nervous system when, in many cases, this system is not involved in the disease process.  
 
The International Association for the Study of Pain (IASP) has authored the diagnostic criteria that define CRPS.  The old method of staging the disease is no longer used and the disorder is now believed to be associated with other neuropathic pain conditions, i.e., pain arising from a disorder of the nervous system.  
 
Treatment of CRPS requires a systematic approach that is developed around a physiotherapeutic algorithm that evolved and was published after a series of consensus meetings led by Dr. Michael Stanton-Hicks.  However, an accurate diagnosis is crucial to treatment and managing the pain of this disorder.  At the Cleveland Clinic Foundation pain management centers patients are afforded, in addition to an interdisciplinary evaluation that meets the needs of each patient, laboratory diagnosis that includes cold pressor testing with thermographic imaging, quantitative sensory testing and sympathetic skin response.  Using the latest technology and other innovative procedures, the Cleveland Clinic Foundation pain management centers provide sophisticated diagnosis and the management of pain.  
 
 
To schedule an appointment or to learn more about the Cleveland Clinic Pain Management centers as well as a location near you call 216-444-PAIN (7246).  

Producer and Host: Lori Schmitt R.N.

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