reflex sympathetic dystrophy

Summary

Summary: A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33)

Top Publications

  1. Okudan B, Celik C. Determination of inflammation of reflex sympathetic dystrophy at early stages with Tc-99m HIG scintigraphy: preliminary results. Rheumatol Int. 2006;26:404-8 pubmed
    The pathogenesis of reflex sympathetic dystrophy (RSD) is not completely understood...
  2. van de Vusse A, Stomp van den Berg S, Kessels A, Weber W. Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type 1 [ISRCTN84121379]. BMC Neurol. 2004;4:13 pubmed
    Complex Regional Pain Syndrome type one (CRPS I) or formerly Reflex Sympathetic Dystrophy (RSD) is a disabling syndrome, in which a painful limb is accompanied by varying symptoms...
  3. Schinkel C, Gaertner A, Zaspel J, Zedler S, Faist E, Schuermann M. Inflammatory mediators are altered in the acute phase of posttraumatic complex regional pain syndrome. Clin J Pain. 2006;22:235-9 pubmed
    ..The pathogenesis of this syndrome is unclear. It has clinical signs of severe local inflammation as a result of an exaggerated inflammatory response, but neurogenic dysregulation also may contribute to it...
  4. Tan A, Duman I, Taskaynatan M, Hazneci B, Kalyon T. The effect of gabapentin in earlier stage of reflex sympathetic dystrophy. Clin Rheumatol. 2007;26:561-5 pubmed
    The objective of this paper is to investigate the effect of gabapentin in the earlier stage of reflex sympathetic dystrophy syndrome (RSD). Twenty-two patients diagnosed with RSD were enrolled. Initial gabapentin dosage was 600 mg/day...
  5. Cappello Z, Kasdan M, Louis D. Meta-analysis of imaging techniques for the diagnosis of complex regional pain syndrome type I. J Hand Surg Am. 2012;37:288-96 pubmed publisher
    ..To compare the effectiveness of imaging techniques in aiding and confirming the diagnosis of complex regional pain syndrome (CRPS) type I...
  6. Perez R, Keijzer C, Bezemer P, Zuurmond W, de Lange J. Predictive value of symptom level measurements for complex regional pain syndrome type I. Eur J Pain. 2005;9:49-56 pubmed
    ..We conclude that the measured pain, temperature, volume and range of motion can be used as diagnostic indicators for establishing presence or absence of CRPS I...
  7. Duman I, Dincer U, Taskaynatan M, Cakar E, Tugcu I, Dincer K. Reflex sympathetic dystrophy: a retrospective epidemiological study of 168 patients. Clin Rheumatol. 2007;26:1433-7 pubmed
    ..factors, duration of symptoms, treatment modalities applied and clinical outcome of the treatment in reflex sympathetic dystrophy (RSD)...
  8. Perez R, Zollinger P, Dijkstra P, Thomassen Hilgersom I, Zuurmond W, Rosenbrand K, et al. Evidence based guidelines for complex regional pain syndrome type 1. BMC Neurol. 2010;10:20 pubmed publisher
    ..Treatment of complex regional pain syndrome type I (CRPS-I) is subject to discussion. The purpose of this study was to develop multidisciplinary guidelines for treatment of CRPS-I...
  9. Coderre T, Bennett G. A hypothesis for the cause of complex regional pain syndrome-type I (reflex sympathetic dystrophy): pain due to deep-tissue microvascular pathology. Pain Med. 2010;11:1224-38 pubmed publisher
    Complex regional pain syndrome-type I (CRPS-I; reflex sympathetic dystrophy) is a chronic pain condition that usually follows a deep-tissue injury such as fracture or sprain. The cause of the pain is unknown...

More Information

Publications62

  1. Coderre T, Xanthos D, Francis L, Bennett G. Chronic post-ischemia pain (CPIP): a novel animal model of complex regional pain syndrome-type I (CRPS-I; reflex sympathetic dystrophy) produced by prolonged hindpaw ischemia and reperfusion in the rat. Pain. 2004;112:94-105 pubmed
    ..ischemia and reperfusion, creating an animal model of complex regional pain syndrome-Type I (CRPS-I; reflex sympathetic dystrophy) that we call chronic post-ischemia pain (CPIP)...
  2. Perez R, Collins S, Marinus J, Zuurmond W, de Lange J. Diagnostic criteria for CRPS I: differences between patient profiles using three different diagnostic sets. Eur J Pain. 2007;11:895-902 pubmed
  3. Breuer B, Pappagallo M, Ongseng F, Chen C, Goldfarb R. An open-label pilot trial of ibandronate for complex regional pain syndrome. Clin J Pain. 2008;24:685-9 pubmed publisher
    Complex regional pain syndrome (CRPS) type I, also known as reflex sympathetic dystrophy, usually develops after trauma or immobilization, is characterized by focal pain and autonomic dysregulation, and sometimes focal trophic changes ..
  4. Eisenberg E, Chistyakov A, Yudashkin M, Kaplan B, Hafner H, Feinsod M. Evidence for cortical hyperexcitability of the affected limb representation area in CRPS: a psychophysical and transcranial magnetic stimulation study. Pain. 2005;113:99-105 pubmed
  5. Kemler M, de Vet H, Barendse G, Van Den Wildenberg F, van Kleef M. Spinal cord stimulation for chronic reflex sympathetic dystrophy--five-year follow-up. N Engl J Med. 2006;354:2394-6 pubmed
  6. Taskaynatan M, Balaban B, Karlidere T, Ozgul A, Tan A, Kalyon T. Factitious disorders encountered in patients with the diagnosis of reflex sympathetic dystrophy. Clin Rheumatol. 2005;24:521-6 pubmed
    b>Reflex sympathetic dystrophy (RSD) may be a misdiagnosis or at least not descriptive enough in patients with atypical hand posture and atypical edema...
  7. Oaklander A, Rissmiller J, Gelman L, Zheng L, Chang Y, Gott R. Evidence of focal small-fiber axonal degeneration in complex regional pain syndrome-I (reflex sympathetic dystrophy). Pain. 2006;120:235-43 pubmed
    ..These results support the hypothesis that CRPS-I is specifically associated with post-traumatic focal MDNI affecting nociceptive small-fibers. This type of nerve injury will remain undetected in most clinical settings...
  8. Schürmann M, Zaspel J, Löhr P, Wizgall I, Tutic M, Manthey N, et al. Imaging in early posttraumatic complex regional pain syndrome: a comparison of diagnostic methods. Clin J Pain. 2007;23:449-57 pubmed
    ..Several diagnostic procedures are applied to facilitate an early diagnosis, although their value for diagnosing posttraumatic CRPS I is unclear...
  9. Heijmans Antonissen C, Wesseldijk F, Munnikes R, Huygen F, van der Meijden P, Hop W, et al. Multiplex bead array assay for detection of 25 soluble cytokines in blister fluid of patients with complex regional pain syndrome type 1. Mediators Inflamm. 2006;2006:28398 pubmed
    ..Ten representative cytokines were detectable. However, detection levels and amounts measured are at least 3 times higher in the multiplex-25 array assay than in the ELISA assays used simultaneously for the measurement of cytokines...
  10. Ringer R, Wertli M, Bachmann L, Buck F, Brunner F. Concordance of qualitative bone scintigraphy results with presence of clinical complex regional pain syndrome 1: meta-analysis of test accuracy studies. Eur J Pain. 2012;16:1347-56 pubmed publisher
    ..To date, no attempt has been made to investigate the agreement between qualitative bone scintigraphy (BS) and the presence of complex regional pain syndrome 1 (CRPS 1) and the agreement between a negative BS in the absence of CRPS 1...
  11. Sigtermans M, Van Hilten J, Bauer M, Arbous M, Marinus J, Sarton E, et al. Ketamine produces effective and long-term pain relief in patients with Complex Regional Pain Syndrome Type 1. Pain. 2009;145:304-11 pubmed publisher
    ..Treatment with ketamine was safe with psychomimetic side effects that were acceptable to most patients...
  12. Frade L, Lauretti G, Lima I, Pereira N. The antinociceptive effect of local or systemic parecoxib combined with lidocaine/clonidine intravenous regional analgesia for complex regional pain syndrome type I in the arm. Anesth Analg. 2005;101:807-11, table of contents pubmed
    ..05). We conclude the IV 5 mg of parecoxib was an effective antiinflammatory drug combined with clonidine/lidocaine loco-regional block in CRPS type 1...
  13. Sahin F, Yilmaz F, Kotevoglu N, Kuran B. Efficacy of salmon calcitonin in complex regional pain syndrome (type 1) in addition to physical therapy. Clin Rheumatol. 2006;25:143-8 pubmed
    ..We can conclude that calcitonin does not make any favourable contribution in the treatment of patients with acute CRPS 1; physical therapy combined with only a simple analgesic is an efficient means of therapy...
  14. Beerthuizen A, Stronks D, van T Spijker A, Yaksh A, Hanraets B, Klein J, et al. Demographic and medical parameters in the development of complex regional pain syndrome type 1 (CRPS1): prospective study on 596 patients with a fracture. Pain. 2012;153:1187-92 pubmed publisher
    ..After a fracture, 7% of the patients developed CRPS1 and none of the patients were free of symptoms at 1-year follow-up...
  15. Maillard S, Davies K, Khubchandani R, Woo P, Murray K. Reflex sympathetic dystrophy: a multidisciplinary approach. Arthritis Rheum. 2004;51:284-90 pubmed
  16. Brunner F, Schmid A, Kissling R, Held U, Bachmann L. Biphosphonates for the therapy of complex regional pain syndrome I--systematic review. Eur J Pain. 2009;13:17-21 pubmed publisher
    ..We performed a systematic review of all randomised controlled trials to assess the benefit of biphosphonates in the treatment of CRPS I patients with bone loss...
  17. Manjunath P, Jayalakshmi T, Dureja G, Prevost A. Management of lower limb complex regional pain syndrome type 1: an evaluation of percutaneous radiofrequency thermal lumbar sympathectomy versus phenol lumbar sympathetic neurolysis--a pilot study. Anesth Analg. 2008;106:647-9, table of contents pubmed publisher
    ..The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar sympathectomy and lumbar sympathetic neurolysis...
  18. Olsson G, Meyerson B, Linderoth B. Spinal cord stimulation in adolescents with complex regional pain syndrome type I (CRPS-I). Eur J Pain. 2008;12:53-9 pubmed
  19. Nickel F, Maihofner C. [Current concepts in pathophysiology of CRPS I]. Handchir Mikrochir Plast Chir. 2010;42:8-14 pubmed publisher
    ..These pathophysiological ideas do not exclude each other. In fact they complement one another. The variety of the involved systems may explain the versatile clinical picture of CRPS...
  20. Vouilloz A, Deriaz O, Rivier G, Gobelet C, Luthi F. Biopsychosocial complexity is correlated with psychiatric comorbidity but not with perceived pain in complex regional pain syndrome type 1 (algodystrophy) of the knee. Joint Bone Spine. 2011;78:194-9 pubmed publisher
    ..characteristics of patients suffering from complex regional pain syndrome type 1 ([CRPS], also known as reflex sympathetic dystrophy or algodystrophy) of the knee with those of a matched group of patients experiencing post-traumatic ..
  21. van de Meent H, Oerlemans M, Bruggeman A, Klomp F, van Dongen R, Oostendorp R, et al. Safety of "pain exposure" physical therapy in patients with complex regional pain syndrome type 1. Pain. 2011;152:1431-8 pubmed publisher
    ..A progressive-loading exercise program and management of pain-avoidance behavior without the use of specific medication ("pain exposure" physical therapy) is safe and effective for patients with complex regional pain syndrome...
  22. Ackerman W, Zhang J. Efficacy of stellate ganglion blockade for the management of type 1 complex regional pain syndrome. South Med J. 2006;99:1084-8 pubmed
    ..The purpose of this study was to examine the efficacy of stellate ganglion blockade (SGB) in patients with complex regional pain syndromes (CRPS I) of their hands...
  23. Groeneweg J, Huygen F, Heijmans Antonissen C, Niehof S, Zijlstra F. Increased endothelin-1 and diminished nitric oxide levels in blister fluids of patients with intermediate cold type complex regional pain syndrome type 1. BMC Musculoskelet Disord. 2006;7:91 pubmed
    ..The aim of this study was to determine the involvement of vasoactive substances endothelin-1 (ET-1) and nitric oxide (NO) during early chronic CRPS1...
  24. Roorda L, Molenaar I, Lankhorst G, Bouter L. Improvement of a questionnaire measuring activity limitations in rising and sitting down in patients with lower-extremity disorders living at home. Arch Phys Med Rehabil. 2005;86:2204-10 pubmed
    ..To improve a self-administered questionnaire that includes 42 dichotomous items and measures activity limitations in rising and sitting down (R&S) in patients with lower-extremity disorders who live at home...
  25. Manicourt D, Brasseur J, Boutsen Y, Depreseux G, Devogelaer J. Role of alendronate in therapy for posttraumatic complex regional pain syndrome type I of the lower extremity. Arthritis Rheum. 2004;50:3690-7 pubmed
    ..To evaluate the effects of the antiresorptive agent alendronate at a daily oral dose of 40 mg in patients with posttraumatic complex regional pain syndrome type I (CRPS I) of the lower extremity...
  26. Albrecht P, Hines S, Eisenberg E, Pud D, Finlay D, Connolly M, et al. Pathologic alterations of cutaneous innervation and vasculature in affected limbs from patients with complex regional pain syndrome. Pain. 2006;120:244-66 pubmed
    ..CRPS type I, also known as reflex sympathetic dystrophy, presents in patients lacking a well-defined nerve lesion, and has been questioned as to whether or not ..
  27. Pleger B, Tegenthoff M, Ragert P, Förster A, Dinse H, Schwenkreis P, et al. Sensorimotor retuning [corrected] in complex regional pain syndrome parallels pain reduction. Ann Neurol. 2005;57:425-9 pubmed
    ..This suggests that the reversal of tactile impairment and cortical reorganization in CRPS is associated with a decrease in pain...
  28. Huygen F, Ramdhani N, van Toorenenbergen A, Klein J, Zijlstra F. Mast cells are involved in inflammatory reactions during Complex Regional Pain Syndrome type 1. Immunol Lett. 2004;91:147-54 pubmed
    ..Involvement of mast cells is relatively easy to detect by measurement of tryptase...
  29. Sigtermans M, Noppers I, Sarton E, Bauer M, Mooren R, Olofsen E, et al. An observational study on the effect of S+-ketamine on chronic pain versus experimental acute pain in Complex Regional Pain Syndrome type 1 patients. Eur J Pain. 2010;14:302-7 pubmed publisher
    ..The aim of the study was to explore the analgesic effect of the N-methyl-d-aspartate receptor (NMDAR) antagonist ketamine in acute experimental versus chronic spontaneous pain in Complex Regional Pain Syndrome type 1 (CRPS-1) patients...
  30. Duman I, Ozdemir A, Tan A, Dincer K. The efficacy of manual lymphatic drainage therapy in the management of limb edema secondary to reflex sympathetic dystrophy. Rheumatol Int. 2009;29:759-63 pubmed publisher
    ..is to investigate the efficacy of manual lymphatic drainage (MLD) therapy in edema secondary to the reflex sympathetic dystrophy (RSD). A total of 34 patients were allocated randomly into two groups...
  31. Perez R, Pragt E, Geurts J, Zuurmond W, Patijn J, van Kleef M. Treatment of patients with complex regional pain syndrome type I with mannitol: a prospective, randomized, placebo-controlled, double-blinded study. J Pain. 2008;9:678-86 pubmed publisher
    ..Whether 10% mannitol can provide beneficial effects for subgroups of CRPS I patients with a pathophysiological profile more closely fitting the presumed mode of action for this intervention remains to be established...
  32. Schasfoort F, Bussmann J, Stam H. Correlation between a novel upper limb activity monitor and four other instruments to determine functioning in upper limb complex regional pain syndrome type I. J Rehabil Med. 2005;37:108-14 pubmed
  33. Dadure C, Motais F, Ricard C, Raux O, Troncin R, Capdevila X. Continuous peripheral nerve blocks at home for treatment of recurrent complex regional pain syndrome I in children. Anesthesiology. 2005;102:387-91 pubmed
  34. Huygen F, Niehof S, Zijlstra F, van Hagen P, van Daele P. Successful treatment of CRPS 1 with anti-TNF. J Pain Symptom Manage. 2004;27:101-3 pubmed
  35. Moseley G. Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain. 2004;108:192-8 pubmed
    ..Although the mechanisms of effect of the MIP are not clear, possible explanations are sequential activation of cortical pre-motor and motor networks, or sustained and focussed attention on the affected limb, or both...
  36. Bant A, Hurowitz B, Hassan N, Du V, Nadir A. Complex regional pain syndrome (reflex sympathetic dystrophy) in a patient with essential mixed cryoglobulinemia and chronic hepatitis C. J Pak Med Assoc. 2007;57:96-8 pubmed
    ..Complex Regional Pain Syndrome type I (CRPS) or Reflex sympathetic dystrophy (RSD) has never been reported in association with HCV...
  37. Harke H, Gretenkort P, Ladleif H, Rahman S. Spinal cord stimulation in sympathetically maintained complex regional pain syndrome type I with severe disability. A prospective clinical study. Eur J Pain. 2005;9:363-73 pubmed
    ..In this prospective trial we assessed the long-term effect of spinal cord stimulation (SCS) on the improvement of functional status in complex regional pain syndrome type I (CRPS I)...
  38. Oaklander A, Fields H. Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy?. Ann Neurol. 2009;65:629-38 pubmed publisher
    ..This was labeled reflex sympathetic dystrophy (RSD; now complex regional pain syndrome type I [CRPS-I])...
  39. Schinkel C, Scherens A, Koller M, Roellecke G, Muhr G, Maier C. Systemic inflammatory mediators in post-traumatic complex regional pain syndrome (CRPS I) - longitudinal investigations and differences to control groups. Eur J Med Res. 2009;14:130-5 pubmed
    ..Some studies investigated the role inflammatory mediators and cytokines; however, few longitudinal studies exist and control groups except healthy controls were not investigated yet...
  40. Moseley G, Wiech K. The effect of tactile discrimination training is enhanced when patients watch the reflected image of their unaffected limb during training. Pain. 2009;144:314-9 pubmed publisher
  41. Collins S, Zuurmond W, de Lange J, van Hilten B, Perez R. Intravenous magnesium for complex regional pain syndrome type 1 (CRPS 1) patients: a pilot study. Pain Med. 2009;10:930-40 pubmed publisher
    ..To explore the feasibility of intravenous magnesium administration as a potential candidate intervention for a large size trial in Complex Regional Pain Syndrome Type 1 (CRPS 1)...
  42. Vaneker M, Wilder Smith O, Schrombges P, Oerlemans H. Impairments as measured by ISS do not greatly change between one and eight years after CRPS 1 diagnosis. Eur J Pain. 2006;10:639-44 pubmed
    ..e. "warm" or "cold", diagnosed according to skin temperature measured via infrared thermometer)...
  43. Groeneweg G, Niehof S, Wesseldijk F, Huygen F, Zijlstra F. Vasodilative effect of isosorbide dinitrate ointment in complex regional pain syndrome type 1. Clin J Pain. 2008;24:89-92 pubmed publisher
    ..Pharmacotherapeutic treatment is generally inadequate...
  44. Gradl G, Gaida S, Finke B, Gierer P, Mittlmeier T, Vollmar B. Exaggeration of tissue trauma induces signs and symptoms of acute CRPS I, however displays distinct differences to experimental CRPS II. Neurosci Lett. 2006;402:267-72 pubmed
    ..Pain perception displays differences to that in CRPS II. Apoptosis turns out to be a distinctive marker for CRPS, warranting further evaluation in clinical studies...
  45. Zollinger P, Tuinebreijer W, Breederveld R, Kreis R. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone Joint Surg Am. 2007;89:1424-31 pubmed
    ..Complex regional pain syndrome type I is treated symptomatically. A protective effect of vitamin C (ascorbic acid) has been reported previously. A dose-response study was designed to evaluate its effect in patients with wrist fractures...
  46. Berthelot J. Current management of reflex sympathetic dystrophy syndrome (complex regional pain syndrome type I). Joint Bone Spine. 2006;73:495-9 pubmed
    Although no major advances have occurred in the curative treatment of reflex sympathetic dystrophy syndrome (RSDS), new pathogenic insights may soon lead to innovative approaches, which may also prove effective in alleviating some forms ..
  47. Moseley G. Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology. 2006;67:2129-34 pubmed
    ..Graded motor imagery is effective for a small subset of patients with CRPS1...
  48. Daly A, Bialocerkowski A. Does evidence support physiotherapy management of adult Complex Regional Pain Syndrome Type One? A systematic review. Eur J Pain. 2009;13:339-53 pubmed publisher
    ..To source and critically evaluate the evidence on the effectiveness of Physiotherapy to manage adult CRPS-1...
  49. Ek J, van Gijn J, Samwel H, Van Egmond J, Klomp F, van Dongen R. Pain exposure physical therapy may be a safe and effective treatment for longstanding complex regional pain syndrome type 1: a case series. Clin Rehabil. 2009;23:1059-66 pubmed publisher
    ..To determine if treatment of longstanding complex regional pain syndrome type 1, focusing on functional improvement only while neglecting pain, results in clinical improvement of this syndrome...
  50. Bolel K, Hizmetli S, Akyuz A. Sympathetic skin responses in reflex sympathetic dystrophy. Rheumatol Int. 2006;26:788-91 pubmed
    ..SSR) in evaluating the sympathetic function and to follow up the effects of sympathetic blockade in reflex sympathetic dystrophy (RSD)...
  51. Higashimoto T, Baldwin E, Gold J, Boles R. Reflex sympathetic dystrophy: complex regional pain syndrome type I in children with mitochondrial disease and maternal inheritance. Arch Dis Child. 2008;93:390-7 pubmed publisher
    Complex regional pain syndrome type I (CRPS-I), previously known as reflex sympathetic dystrophy (RSD), is an idiopathic condition characterised by localised, abnormally intense and prolonged pain, allodynia and autonomic nervous system ..
  52. Schattschneider J, Hartung K, Stengel M, Ludwig J, Binder A, Wasner G, et al. Endothelial dysfunction in cold type complex regional pain syndrome. Neurology. 2006;67:673-5 pubmed
    ..No significant differences were found after application of sodium nitroprusside. The results demonstrate impaired endothelial function in chronic CRPS I...
  53. Zyluk A. The usefulness of quantitative evaluation of three-phase scintigraphy in the diagnosis of post-traumatic reflex sympathetic dystrophy. J Hand Surg Br. 1999;24:16-21 pubmed
    Quantitative analysis of three-phase bone scintigrams was done in 70 patients with reflex sympathetic dystrophy (RSD) and in 30 patients who did not have RSD after injury to the hand or wrist...