What is Reflex Sympathetic Dystrophy?

Woman holding her arm.

Reflex sympathetic dystrophy is a painful nerve problem that can rarely occur in the hand or foot  or other area that has been hurt or has never been hurt. If untreated, the pain and weakness that RSD may cause can limit use of the injured region.

Reflex sympathetic dystrophy (RSD) is also known as complex regional pain syndrome (CRPS, Type 1). CRPS type 2 was formerly called causalgia.  RSD or CRPS-1 is the term used when there is no prior nerve injury.  CRPS-2 is used when there has been prior nerve injury. Both have the same symptoms and clinical picture.

What triggers RSD?

The cause of RSD is unknown. CRPS-2 may be caused by injury. Getting injured may trigger RSD. It can be something minor, like a sprain or a cut. Or, it may be more severe, like a fracture or a surgery, such as carpal tunnel release. As you’re healing, you may feel new, severe pain in the injured region. That pain may spread through the injured limb. Over time, other symptoms may appear.

Symptoms and signs of RSD

If you aren’t treated soon, the symptoms of RSD can worsen or change over time. Below are symptoms and signs that can occur in the injured region:

Early-stage RSD

Symptoms include:

  • Severe, burning pain

  • Sensitive to touch (pain from physical contact that normally would not be painful) 

  • Swollen, reddish or purple look

  • Stiffening

  • Change in temperature to the affected body part

  • Warm and sweaty sensation Woman talking with her health care provider.

Late-stage RSD

Symptoms include:

  • Skin slowly withering

  • Skin that becomes dry and shiny

  • Loss of strength

  • Strange hair growth

  • Nail changes

  • Ridges in skin look flatter than normal

  • Shrinkage of the affected limb

  • Constant swelling of the foot or hand

  • Speading to other limbs

  • Abnormal movements of the involved extremity such as tremor and involuntary movements



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