Reflex Sympathetic Dystrophy Syndrome (RSDS) is medically defined as a “rare” disorder. Yet, it has recently become a common claim following litigated injuries. Claims of this disorder are increasing faster than medical technology, making the job of claims handlers—and litigators alike—extremely difficult. Unfortunately, RSDS can be difficult to diagnose because its symptoms are mostly subjective in nature. As a result, few doctors are experienced in treating the syndrome. Doctors need to know more about RSDS to ensure proper diagnosis and treatment. Claims handlers need to be informed about RSDS to have successful claim management.DEFINITIONRSDS is a rare disorder of the sympathetic nervous system, which regulates involuntary bodily functions. It can increase heart rate and blood pressure. It can also constrict blood vessels. RSDS can also be referred to as: Algodystrophy, Algoneurodystrophy, Causalgia Syndrome (Major), Reflex Neurovascular Dystrophy, Sudeck's Atrophy, or Complex Regional Pain Syndrome. Claims handlers and doctors should be familiar with this terminology.SIGNS & SYMPTOMSUsually, RSDS clinically progresses through three stages--acute, dystrophic, and atrophic. Each stage lasts from three to six months. RSDS symptoms begin with burning pain in the arm(s), finger(s), palm(s) and/or shoulder(s). The skin over the affected area(s) may become swollen (edema) and inflamed. Affected skin may be extremely sensitive to touch and sensitive to hot or cold temperatures (cutaneous hypersensitivity). The affected limb(s) may perspire excessively and be warm to the touch (vasomotor instability). In some individuals, RSDS may occur in one or both legs or it may be localized to one knee or hip. TREATMENTThe most widely used therapy for the condition has been cervical or lumbar paravertebral sympathetic blockade with anesthetics such as mepivacaine or bupivacaine. The pain relief may be dramatic, with a duration outlasting the action of the anesthetic. Several regional blockade procedures have been developed using a modified Bier block. The administration of corticosteroids has also been advocated. Another therapy for this disorder is therapeutic exercise and hand conditioning. A coordinated multidisciplinary approach to treatment seems to work best.REASONS TO GET AN IME FOR RSDS CASESCausation: The exact cause of RSDS is not fully understood, although it may be associated with injury to the nerves, trauma, surgery, atherosclerotic cardiovascular disease, infection or radiation therapy. It can occur following sprain, fracture, or injury to nerves or blood vessels, particularly in the extremities. As a result, a neurologist familiar with RSDS will understand appropriate signs and symptoms and should be able to confirm the diagnosis Save Treatment Dollars: Frequently, RSDS may go undiagnosed. It can also be misdiagnosed as a painful nerve injury. Therefore, a neurologist who has had experience in diagnosing and treating the disease can save significant treatment dollars.Permanence: Diagnosis is important in determining treatment. However, in one large study, 60% of patients had continuing pain regardless of treatment. The pain may be excruciating, resulting in dramatic physical and psychological alterations. An experienced neurologist, who is familiar with RSDS, will be able to diagnose and recommend appropriate treatment.Medical Systems, Inc. offers several neurologists familiar with the diagnosis, treatment, and evaluation of RSDS. Call: 800-261-3278 to schedule.
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