Reflex sympathetic dystrophy (RSD) is a type of complex regional pain syndrome (CRPS). This condition occurs because of malfunctions in your sympathetic nervous system and immune system. RSD causes severe pain in one or more limbs that lasts months or longer.

In general, the condition develops after an injury or other medical condition. RSD can lead to many physical and emotional symptoms. A variety of treatments are available for RSD, and it’s important to get treated early to prevent worsening of your symptoms.

Learn more about your nervous system »

RSD occurs in the extremities. It most commonly affects the upper limbs, but it’s possible to get it in your lower limbs as well. Specifically, you may experience RSD in your:

  • hands
  • fingers
  • arms
  • shoulders
  • legs
  • hips
  • knees

Symptoms include:

  • stiffness
  • discomfort
  • pain or burning sensation
  • swelling
  • sensitivity to heat or cold
  • weakness
  • feeling warm to the touch
  • skin redness
  • skin paleness with a blue tone
  • tenderness
  • sweating around the affected area
  • changes to the skin in the affected area
  • muscle weakness
  • muscle spasms
  • muscle atrophy
  • joint pain and stiffness
  • nail and hair changes

Most symptoms begin at the site of the condition but may spread as RSD progresses. You may have symptoms on one side but notice them in your opposite limb as the condition worsens. Symptoms may begin as mild and then become more severe, interfering with your daily life.

Your mental health can also be affected with RSD. You may experience anxiety, depression, or post-traumatic stress disorder related to the condition.

RSD occurs when your sympathetic nervous system and immune system malfunction because of nerve damage. It affects up to 200,000 Americans annually. The damaged nerves misfire, sending your brain excessive signals of pain from the affected area.

According to the National Institute of Neurological Disorders and Stroke, 90 percent of people with CRPS can point to their medical history to determine what caused the condition. Many underlying conditions and factors can lead to RSD, including:

  • trauma, such as fractures, broken bones, or amputation
  • infection
  • soft tissue injuries such as burns and bruises
  • sprains
  • radiation therapy
  • cancer
  • surgery
  • paralysis of one side of the body
  • heart attack
  • emotional stress
  • nerve pressure
  • stroke

You may also experience RSD with no prior medical condition. Your doctor will try to determine the cause of the RSD if this is the case.

You may be more susceptible to RSD if you:

There isn’t a definitive test for RSD. Your doctor will need to take your medical history, conduct several tests, and perform a thorough physical examination. It’s important to diagnose the condition early to prevent it from getting worse, though diagnosis isn’t always straightforward. You may wait for many months or even longer before your doctor diagnoses RSD.

Tests your doctor may perform include:

Your doctor may check for other medical conditions before diagnosing RSD. These conditions are treated differently than RSD. They include:

Early treatment is imperative to stop RSD from worsening or spreading. However, early treatment can be difficult if it takes time to diagnose the condition.

Treatments for RSD vary. Certain interventions and medications may help relieve and treat symptoms. You may also seek physical therapy and psychotherapy to reduce the effects of RSD. You may find that your condition improves dramatically with treatment, but some people have to learn how to manage their symptoms.

Medical procedures

Interventions for RSD include:

  • transcutaneous electrical nerve simulation
  • biofeedback
  • peripheral nerve blocks
  • spinal cord stimulation
  • pump implantation
  • sympathectomy, either chemical or surgical, which destroys some of your sympathetic nerves
  • deep brain stimulation
  • intrathecal (in the spine) drug pumps
  • electroacupuncture


A variety of medications are available for RSD, ranging from over-the-counter pain relievers and topical creams to prescription drugs from your doctor. These medications include:


Physical therapy may help you rehabilitate the affected limb. This type of therapy will ensure that you continue to move the limb to retain its abilities. It also improves your blood flow and reduces symptoms related to circulation problems. Regular physical therapy may be needed to reduce symptoms.

Seeing a health professional for psychotherapy may also be necessary with RSD. You may develop a psychological condition from the chronic pain associated with the condition. Psychotherapy will help you manage your mental health.

You may also find that complementary alternative therapies like acupuncture or relaxation methods work for treating your RSD.

While some research discusses the prevention of RSD for specific cases, there is no conclusive evidence that a person can avoid RSD completely.

People who’ve had a stroke should be mobilized soon afterward to avoid developing RSD. If you’re taking care of a loved one with a stroke, help them get up and walking around. This movement may also be useful to people who’ve had heart attacks.

Read more: What to expect when recovering from a stroke »

Taking daily vitamin C after a fracture may also decrease your chances of CRPS.

RSD can result in a variety of outcomes. You may find that early intervention and treatment minimizes your symptoms and allows you to return to life as usual. On the other hand, your symptoms may get worse and may not be diagnosed in a timely fashion. In these cases, it’s necessary to learn how to best manage your symptoms for the fullest life possible.