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.
Reflex sympathetic dystrophy (RSD) is characterized by a group of symptoms including pain (often
"burning" type), tenderness, and swelling of an extremity associated with
varying degrees of sweating, warmth and/or coolness, flushing,
discoloration, and shiny skin.
How RSD occurs is not known, but there are often triggering events.
Symptoms of RSD often occur in three stages: 1) acute, 2) dystrophic, and
3) atrophic.
Diagnosis of RSD is based on clinical findings, supported by radiological
tests.
Treatment of RSD is most effective in the earlier stages.
What is reflex sympathetic dystrophy (RSD)?
Reflex sympathetic dystrophy (RSD) is a condition that features a group of typical symptoms, including pain (often "burning" type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin. RSD is also referred to as
"complex regional pain syndrome," "the shoulder-hand syndrome," "causalgia," and "Sudeck's atrophy."
What causes reflex sympathetic dystrophy (RSD)?
The exact mechanism of how RSD develops is poorly understood. The theories include irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin. The involuntary nervous system, peripheral nerves, and brain seem to be involved.
A variety of events can trigger the RSD, including:
There is no associated or identified inciting event in one-third of individuals
with RSD. Fibromyalgia has been reported to coexist with RSD in some
people.
What are the symptoms of reflex sympathetic
dystrophy (RSD)?
The onset of RSD symptoms may be rapid or gradual. The condition may not
display all features. It is bilateral (involving both sides of the body) in
up to half of people with RSD. There are several stages of RSD with symptoms
that include:
Acute (three to
six months): burning, flushing, blanching, sweating, swelling, pain, and
tenderness. This stage can show early X-ray changes of patchy bone
thinning.
Dystrophic (three to six months): early skin changes of
shiny, thickened skin and contracture with persistent pain, but diminished
swelling and flushing.
Atrophic (may be long-standing): loss of
motion and function of the involved hand or foot with contracture (flexed
scarring process), and thinning of the fatty layers under the skin. X-ray
can show significant osteoporosis.
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.
Introduction to Complex regional pain syndrome (CRPS)
Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy syndrome, is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. Experts believe that CRPS occurs as a result of dysfunction in the central or peripheral nervous systems.
CRPS is most common in people aged 20-35. The syndrome also can occur in children; it affects women more often than men.
There is no cure for CRPS.
What Causes Complex Regional Pain Syndrome?
CRPS most likely does not have a single cause but rather results from multiple causes that produce similar symptoms. Some theories suggest that pain receptors in the affected part of the body become responsive to catecholamines, a group of nervous system messengers. In cases of injury-related CRPS, the syndrome may be caused by a triggering of the immune response which may lead to the inf...