Reflex Sympathetic Dystrophy (RSD) Syndrome

[Wayne Renardson]

One day Andrew Bell asked about RSD:

This from.....hmmmmm  I cannot recall Andrew. So I know nothing about the 
veracity of the info. It seems someone posted it to AMP-L not too long ago.   
Sorry I cannot give you more info. 

Glad to have ya back. 

Wayne Renardson
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Reflex Sympathetic Dystrophy (RSD) Syndrome is a progressive disease of 
the Autonomic Nervous System that can follow a simple trauma (fall or 
sprain) a break or fracture (especially wrist and ankle) a sharp force injury 
(such as a knife or bullet wound), heart problems, infections, surgery, 
RSI/CTS, spinal injuries/disorders, or major trauma.  

It is a multi-symptom condition affecting one, two, or sometimes even all four 
of the extremities. It can also be in the face, shoulders, back, eyes, and other 
areas as well. It may spread from one part of the body to another regardless of 
where the original injury occurred; and RSD can spread in up to 70% of the 
cases.(1)  

In a small number of cases it can become Systemic or body-wide. RSDS 
involves nerves, skin, muscles, blood vessels (causing constriction and pain) as 
well as bones.   

ANYONE can get RSDS. There are millions of women, men, and children 
across the United States with this disease. It affects women many more times 
than men, maybe as high as four or five to one, and affects all age groups from 
3 to 103.(1)  

1 - According to a National Survey done in 1998 by the National RSDHope 
Group of 809 RSD Patients. 
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I have done tons of research on RSD and my residency project will be on this 
topic as well (because I suffer from it).  For patients with RSD, amputation IS 
NOT recommended.  It is a contraindication.  The reason for this is that RSD 
is a progressive disorder and many times after amputation is done, RSD 
develops in the remaining stump. It will then travel because that extremity has 
experienced excessive trauma.  THIS IS NOT RECOMMENDED. 
Furthermore, I have traveled all over to Dr.'s around the country, and found 
one that is THE BEST in treating RSD.  I can almost guarantee relief from 
this person.   

My thoughts on this subject are that RSD is a little known disorder. With the 
limited research on it, no one can determine the cause or cure. I have dealt 
with several patients and a family member that have RSD, and it is a very 
difficult task to treat. It is an even greater task to understand what these 
people experience. My fear for your patient is that if an amputation does take 
place, who is to say that the disease does not spread.  I have had a few 
patients where that has happened, and it is even more traumatic than dealing 
with it in the first place. Can cause even the strongest of individuals to slip  
into depression.  

My suggestion is to tell your patient to explore all avenues before continuing 
with an amputation.  

Encourage the patient to try a course of true elevation of the lower 
extremities, by which I mean feet higher than knees, knees higher than hips, 
hips higher than heart. This can be done by laying on a sofa with the head 
cushion removed and added the the foot area and try to stay down in this  
position for an extended time. Most people with swollen extremities report the 
feeling of the water starting to soon flow from the swollen limb. Then other 
conventional methods of orthotic support can be tried if this helps, the cost is 
cheap and benefits can be very efficient.  

I've worked with several RSD patients. First one elected amputation with no 
relief of the pain.  Watch him go slowly downhill, get depressed  and 
eventually commit suicide.  It was an eye opening experience and a very sad 
one.  I have not EVER heard of a case of RSD who elected amputation and 
had success. I would advise this gentleman to really research amputation as an 
elective because it likely won't help the situation.  

I am dealing with a RSD case now and am also in that debating phase. They 
are really so different that it is difficult to offer advice.  I was honest with my 
lady and stated very clearly that my orthosis may not assist with her pain at all.  
I say it's just like medicine. Sometimes it's successful, sometimes it helps a 
little, other times it is rendered totally useless.  

RSD is a very horrible thing.  My advice is to treat the PROBLEM and not the 
PAIN.  I don't think you'll be successful at reducing the pain.  Don't end up 
being the escape goat and explain this to your patient right up front.  

NO.....although Dr. Hooshmand and Hashmi have done lots of RSD research 
and I am sure are very fine Dr.'s for this disease. I have found one that I as 
well as many others feel is the best in the country. He is at Cleveland Clinic 
and his name is Dr. Stanton-Hicks. He has done lots of research and written 
many pieces on RSD. He also sees hundreds of patients a month with this 
disorder.  I was on crutches for five months before treatment through Dr. 
Stanton-Hicks. Although I still have lots of pain, I am off crutches and 
working on P.T. to decrease the pain and ROM.  If you have any other  
questions or comments, do not hesitate to call or write.