The word “misfire” is an appropriate term to use when discussing reflex sympathetic dystrophy or RSD. This is a condition in which the nerves send inaccurate signals to the brain, and create what many describe as an abnormally high pain response to a minor or even non-existent issue. For example, it is not unusual for someone with RSD to get a paper cut or small injury to a finger and feel a tremendous amount of pain or discomfort from such a minor issue.
So, just why does this happen? The disproportionate pain of RSD is due to some sort of malfunction in the nerves following an actual injury, surgery, or trauma. What experts believe is that injury or damage to a nerve may have been sustained and this provokes the future overreactions and hyper responses to any pain stimulus in the future. Experts tend to break RSD into to “types” – the kind after an injury, which should not have affected the nerve and an actual injury to a nerve (AAOS.org, 2015).
Indicators of RSD
Knowing that RSD can result from actual nerve damage or following an injury is helpful in recognizing it when it appears. Additionally, knowing that the experience of pain is far out of proportion with the incident is another useful indicator for diagnosing the condition.
Many with RSD also describe pain as constant or burning when an injury occurs, and generally lasting much longer than what one would expect from the specific injury received. When it occurs in the hands, it comes with a set of additional characteristics that help to make the diagnosis.
For one, the extremity is often swollen and quite warm to the touch. There may be pronounced perspiration and a shiny appearance to the skin, and hands with RSD may also be immobile or limited in their range of motion.
Unfortunately, the symptoms of RSD can vary quite widely from one person to the next, and so it is impossible to draw a conclusion without a more in-depth analysis by a hand doctor. One thing that does seem to apply to all cases is that the earlier the treatment can begin, the better the outcome. Anyone concerned that they are experiencing disproportionate pain in their hands after an injury should, therefore, head to the physician as soon as possible.
They will explore the patients history while also using diagnostic tools such as bone scans, thermography, and X-rays.
Once it is confirmed that RSD is indeed an issue, there are a few ways it can be treated. The primary goal is to reduce or eliminate pain. This can be done in several ways that include medications such as topical pain relievers, steroids, and others. There is also basic therapy that can restore function and reduce pain. There is a process that is used to numb the stellate ganglion, which is a group of sympathetic nerves. This allows therapy to be more effective by eliminating pain temporarily while treatment is done. There is also psychotherapy as well as surgery.
It is impossible for a hand doctor to predict the outcome of any treatment, but all agree that it is a “sooner the better” sort of issue. So if you feel you have RSD or suspect a loved one has developed it, get to your hand doctor immediately.
AAOS.org. Complex Regional Pain Syndrome. 2015. http://orthoinfo.aaos.org/topic.cfm?topic=a00021