RSD Stages

What causes RSD / CRPS?

The medical community isn’t sure what causes RSD / CRPS. In some cases the sympathetic nervous system plays an important role in sustaining the pain. The most recent theories suggest that pain receptors in the injured or affected part of the body become responsive to a family of nervous system messengers known as catecholamines. The incidence of sympathetically maintained pain in reflex sympathetic dystrophy is not known. Some medical experts believe that the importance of the sympathetic nervous system depends on the stage of the disease.

Another theory is that post-injury CRPS Type 2 (CRPS II) is caused by a triggering of the immune response, which leads to the characteristic inflammatory symptoms of redness, warmth, and swelling in the affected area. CRPS may therefore represent a disruption of the healing process. In all likelihood, CRPS does not have a single cause, but is rather the result of multiple causes that produce similar symptoms.

CRPS / RSD Diagnosis

CRPS is diagnosed primarily through observation of the signs and symptoms. But because many other conditions have similar symptoms, it can be difficult for doctors to make a firm diagnosis of CRPS early in the course of the disorder when symptoms are few or mild. Or, for example, a simple nerve entrapment can sometimes cause pain severe enough to resemble RSD. Diagnosis is further complicated by the fact that some people will improve gradually over time without treatment.

Since there is no specific diagnostic test for CRPS, the most important role for testing is to help rule out other conditions. Some clinicians apply a stimulus (such as touch, pinprick, heat, or cold) to the area to see if it causes pain. Doctors may also use triple-phase bone scans to identify changes in the bone and in blood circulation.

CRPS / RSD Symptoms

The key symptoms of RSD pain include continuous, intense pain out of proportion to the severity of the injury, which gradually gets worse rather than improving over time. Complex regional pain syndrome most often affects one of the extremities (arms, legs, hands, or feet) and is also often accompanied by:

• “burning” pain

• increased skin sensitivity

• changes in skin temperature: warmer or cooler compared to the opposite extremity

• changes in skin color: often blotchy, purple, pale, or red

• changes in skin texture: shiny and thin, and sometimes excessively sweaty

• changes in nail and hair growth patterns

• swelling and stiffness in affected joints

• motor disability, with decreased ability to move the affected body part

• motor disability, with decreased ability to move the affected body part

Often the pain spreads to include the entire arm or leg, even though the original injury might have been only to a specific body part such as a hand or foot. Pain can sometimes even travel to the opposite extremity. It may be heightened by emotional stress.

The symptoms of regional sympathetic dystrophy vary in severity and length. Some doctors believe there are three stages associated with CRPS, marked by progressive changes in the skin, muscles, joints, ligaments, and bones of the affected area, although many people will have different experiences this progression has not yet been supported by clinical research studies. Patients with an RSD diagnosis will often state that “RSD has a mind of its own” because of the unpredictable nature of the pain syndrome.

Stage one is thought to last from 1 to 3 months and is characterized by severe, burning pain, along with muscle spasm, joint stiffness, rapid hair growth, and alterations in the blood vessels that cause the skin to change color and temperature.

Stage two lasts from 3 to 6 months and is characterized by intensifying pain, swelling, decreased hair growth, cracked, brittle, grooved, or spotty nails, softened bones, stiff joints, and weak muscle tone.

In Stage three the syndrome progresses to the point where changes in the skin and bone are no longer reversible. Pain becomes unyielding and may involve the entire limb or affected area. There may be marked muscle loss (atrophy), severely limited mobility, and involuntary contractions of the muscles and tendons that flex the joints. Limbs may become contorted.

If you or a family member suffers from RSD symptoms caused by an injury please contact us and an RSD attorney from Fields Law Firm will answer any of your questions and explain your legal options.