Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
How is reflex sympathetic dystrophy (RSD) diagnosed?
RSD is diagnosed based on the clinical features described previously. Blood tests are not abnormal because of RSD, though the associated triggering events mentioned
previously may lead to abnormalities in laboratory testing. Plain film X-ray testing and
MRI scanning can show patchy thinning or significant osteoporosis. Nuclear bone scanning can
show characteristic uptake patterns.
What is the treatment for reflex sympathetic
dystrophy (RSD)?
Response to treatment of RSD is greater in the earlier stages of the condition than in the later stages.
Cool, moist applications to the affected areas can provide some relief
of burning symptoms.
Gradual exercise can help prevent contractures.
Medications for pain and inflammation can also reduce symptoms.
For persisting symptoms, high doses of
prednisone (cortisone) may be used for periods of weeks, depending on the response, and then gradually reduced.
Other medications that may be of benefit include
amitriptyline (Elavil,
Endep), pregabalin (Lyrica), and
clonidine (Catapres,
Catapres=TTS, Jenloga).
Occasionally, a nerve block with anesthetic injected into a specialized area of the involuntary nervous system (for example, a stellate ganglion blockade) can help both in treatment and in establishing the diagnosis. Sometimes a series of these blocks is tried.
Other treatments include surgically interrupting the nerves (the sympathetic nerves) of the involuntary nervous system (surgical sympathectomy), implanting pumps with pain medication into the spinal canal (intrathecal drug pumps), and spinal cord stimulation devices.
Complex regional pain syndrome is a chronic pain condition in which high levels of nerve impulses are sent to an affected site is called complex regional pain syndrome (CRPS). CRPS is most common in people aged 20-35. The syndrome also can occur in children; it affect women more often than men.
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