Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy
A poorly understood, disease phenomenon characterized by pain, swelling, discoloration, and stiffness of an extremity.

“…evaluation of the previous literature is rendered virtually worthless in the light of the new concepts (of sympathetically maintained pain). There are no papers previously published with valid criteria for the condition, properly controlled interventions, or valid and objective outcome measures.”
– Peter R. Wilson, MBBS, PhD in Post-Traumatic Upper Extremity Reflex Sympathetic Dystrophy
Hand Clinics, Volume 13, Number 3, August 1997.

TERMINOLOGY

Mitchell, 1867. “causalgia” – “causos” (heat) and “algos” (pain) – burning pain.
Sudeck, 1900. “Sudeck’s atrophy”.
Leriche, 1922. sympathetic nervous system involvement
Spurling, 1930. dorsal sympathetic ganglionectomy for treatment.

Major causalgia – burning pain, autonomic dysfunction, limb atrophy following incomplete nerve injury

Minor causalgia – similar (and somewhat less severe) symptoms after minor trauma (or no obvious injury) without identified nerve injury.

major and minor post-traumatic dystrophy reflex nervous dystrophy
traumatic neuralgia post-traumatic osteoporosis
sympathalgia traumatic angiospasm
traumatic vasomotor disorder shoulder-hand syndrome
causalgia-like states Sudeck’s atrophy, Sudeck’s syndrome, Mitchell’s causalgia Homan’s minor causalgia.

Richards, 1967. Suggested the term “reflex sympathetic dystrophy” be universally accepted as the proper title for the syndrome.