What is RSD of the wrist? RSD stands for Reflex Sympathetic Dystrophy and while it can strike anyone, it most often affects those ages 25 to 55. Women are three times more likely to have RSD. It usually appears as a constant, severe burning pain with highly increased sensitivity in the wrist. It normally shows up following a sprain, cut or a minor injury. An estimated three to six million Americans suffer from RSD.
The most common symptoms are burning and electrical sensations (shooting pain). Other symptoms can include:
- Muscle spasms
- Increased sweating
- Softening or thinning of the bones
- Local swelling
- Joint tenderness and stiffness
- Restricted or painful movement
- Change in skin texture or color
- Abnormal hair or nail growth
The three stages of RSD are:
- Stage 1 - Severe burning at the site of injury, joint stiffness, and restricted mobility.
- Stage 2 - More intense pain, swelling spreads, nails become more brittle, cracked and grooved.
- Stage 3 - Irreversible changes in skin and bones; limb can become displaced from its normal position.
The pain of RSD can be increased by emotional or physical stress.
There is no simple cure for RSD, and treatment is aimed at relieving the painful symptoms so patients can resume normal activities and use the wrist as much as possible in everyday life. The earlier the diagnosis is made, the better the chance of a full recovery.
A bone scan can detect changes as soon as two weeks after the onset and can monitor the results of treatment. An EMG (electromyography testing) should be done for the diagnosis of RSD, although it can be painful for patients suffering from RSD. There is no simple test available to diagnosis RSD.
A variety of drugs are used to treat RSD, including antidepressants, anti-inflammatories such as cortisone, anti-seizure drugs, and opioids.
A physical or occupational therapy exercise program will improve the range of motion for the wrist. Do not ice the area, as this is not good for RSD. In fact, ice can actually exacerbate the condition.
Treatment blocks such as Ketamine, an anesthetic used in the treatment of RSD, have had great success. It is a safe and effective treatment. It blocks NMDA receptors, which might reboot brain activity. During the infusion, the patient is monitored constantly; this treatment should be done by a qualified physician such as an anesthesiologist. Lidocaine is sometimes used.
A surgery known as sympathetectomy is also available. It divides sympathetic nerves in patients that are helped with nerve blocks.
Though RSD of the wrist is not curable, it is manageable. A qualified physician can help you to decide on a proper course of treatment and the best exercise program. The proper diagnosis and treatment are essential for RSD.
Photo courtesy of KathyR2005’s photostream from Flickr.com:
This post is part of the series: Hand & Wrist Disorders and Diseases
Disorders and diseases of the hand and wrist can cause pain and reduce ihdependence, especially in the elderly. There are many non-surgical treatments available today, that make treatment much less invasive.