What is Reflex Sympathetic Dystrophy?
Reflex Sympathetic Dystrophy which is now known as Complex Regional Pain Syndrome type-1 is a disorder of the nerves characterized by low threshold for pain meaning that a person with this condition tends to feel immense pain. This pain is normally felt in the extremities. People with Reflex Sympathetic Dystrophy also may complain of abnormal sweating, decreased range of motion of the extremities, and an overall change in body temperature.[1,2,3]
Reflex Sympathetic Dystrophy affects the nerves both in the central and sympathetic nervous systems. It is the sympathetic nervous system that controls body’s involuntary responses to pain and stress. Another form of CRPS is CRPS type-2 which is a different condition but has some common characteristics to Reflex Sympathetic Dystrophy or CRPS-1 and this is the reason why physicians have some difficulty in accurately diagnosing Reflex Sympathetic Dystrophy.[1,2,3]
What Causes Reflex Sympathetic Dystrophy?
There are many factors that are at play when it comes to the causes of Reflex Sympathetic Dystrophy. These factors include some type of abnormality in the transmission of signals from the nerves or an oversensitive nervous system. Some sort of dysfunction in the autonomic nervous system can also be one of the factors responsible for Reflex Sympathetic Dystrophy. Why do these abnormalities occur is debatable but researchers feel that genetic makeup, psychological issues, or inflammation or a combination of all of the three may be at play.[3]
What are the Symptoms of Reflex Sympathetic Dystrophy?
The primary symptom of Reflex Sympathetic Dystrophy is low pain threshold. This is medically termed as allodynia. A person with allodynia will feel pain even with slightest touch. Another symptom that is commonly seen in people with Reflex Sympathetic Dystrophy is hyperalgesia. A person with hyperalgesia will be overly sensitive to painful stimuli.[3]
The blood vessels and sweat glands also get affected in people with Reflex Sympathetic Dystrophy which also cause a variety of symptoms including abnormal sweating, changes in body temperature, and changes in skin color. In some cases, the symptoms of Reflex Sympathetic Dystrophy are more widespread and involve multiple organs of the body. When the digestive system is involved the individual may experience digestive issues, nausea, vomiting, and constipation alternating with diarrhea.[3]
When the cardiovascular and respiratory system is involved then the individual will experience involuntary contractions in the chest wall, chest pain with shortness of breath, and loss of consciousness. If the urinary system gets involved with Reflex Sympathetic Dystrophy then the symptoms experienced will include increased urinary frequency and urinary incontinence at times.[3]
Reflex Sympathetic Dystrophy can also at times cause memory problems or problems with finding the exact word to speak when the nervous system gets affected with Reflex Sympathetic Dystrophy. Other symptoms seen in individuals with Reflex Sympathetic Dystrophy include sleep issues, fatigue, low energy levels, weakness, and decreased mobility of the affected extremities.[3]
How is Reflex Sympathetic Dystrophy Treated?
It is common to see the symptoms of Reflex Sympathetic Dystrophy improve with time. However, in some cases the symptoms may progress and the person ends up having chronic pain conditions. As of now, there are no specific treatments for Reflex Sympathetic Dystrophy; however, generally a multidisciplinary approach is adopted to treat the symptoms with physical therapy, occupational therapy, and other specialists being involved.[3]
The physician may recommend medications to manage the symptoms of Reflex Sympathetic Dystrophy to include oral corticosteroids, anticonvulsants like Neurontin, antidepressants like Cymbalta, and in rare cases opioids. These medications may be administered alone or in combination. Other treatments include vitamin C supplements, topical capsaicin, nerve blocks to block pain perception, and sympathetic ganglion blocks.[3]
A procedure called neuromodulation is also believed to be effective in controlling the symptoms of Reflex Sympathetic Dystrophy. This procedure involves use of targeted medications and electrical impulses to alter nerve activity. Spinal cord stimulation which is a procedure through which electrical impulses are delivered to the spinal cord to mask pain signals before they can reach the brain. Some people have found cognitive behavioral therapy also to be quite useful in managing the symptoms of Reflex Sympathetic Dystrophy.[3]
However, a study done in 2013 on the treatment strategies for Reflex Sympathetic Dystrophy concluded that the efficacy of the treatments mentioned above are quite variable where some people find it effective there are others who do not see any improvements in their symptoms. The researchers believe that more work needs to be done to come up with better treatments that are consistently effective in the treatment of Reflex Sympathetic Dystrophy.[3]
What Is The Prognosis Of Reflex Sympathetic Dystrophy?
As stated, there are many cases where the symptoms of Reflex Sympathetic Dystrophy improve with time but some people go on to develop chronic pain disorders. Additionally, the study done in 2013 states that further research is needed to find more effective ways to treat Reflex Sympathetic Dystrophy. However, since Reflex Sympathetic Dystrophy is not seen in many people it is quite difficult to find participants for research.[3]
In conclusion, Reflex Sympathetic Dystrophy is a disorder of the nerves that decreases the pain threshold in a person resulting in the person feeling severe pain even with slightest of touch or non-painful stimuli. Reflex Sympathetic Dystrophy usually affects the extremities resulting in the affected limbs having decreased range of motion. This condition also may involve other body systems which have been described above in detail.[1,2,3]
There is no specific treatment for Reflex Sympathetic Dystrophy but it involves a multidisciplinary approach with a team of specialists formulating a treatment plan for the patient. There are a variety of medications and procedures that may alter the nerve activity and alter the pain perception and also are quite effective in managing the symptoms of this condition. However the response to treatment is quite variable and research is ongoing to find out treatments that are effective for everyone with Reflex Sympathetic Dystrophy.[1,2,3]
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