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Reflex sympathetic dystrophy

R J Schwartzman1

  • 1Jefferson Medical College, Philadelphia, Pennsylvania.

Current Opinion in Neurology and Neurosurgery
|August 1, 1993
PubMed
Summary
This summary is machine-generated.

Reflex sympathetic dystrophy, a progressive illness often caused by nerve trauma, involves pain, edema, and autonomic dysfunction. Pain mechanisms shift from sympathetic dependence to independence, involving complex neural pathways.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Physiology

Background:

  • Reflex sympathetic dystrophy (RSD) is a progressive condition initiated by nerve trauma.
  • It presents with pain, edema, autonomic dysfunction, movement disorders, and trophic changes.
  • RSD symptoms can manifest in stages and may affect different body parts sequentially.

Purpose of the Study:

  • To elucidate the complex mechanisms underlying pain in reflex sympathetic dystrophy.
  • To explore the transition of pain from sympathetic dependence to independence.
  • To identify the neural pathways and receptors involved in RSD pain.

Main Methods:

  • Analysis of the five components of reflex sympathetic dystrophy.
  • Investigation into the temporal evolution of illness stages and sensitization.

Related Experiment Videos

  • Examination of the roles of alpha 1 adrenoreceptors, C-nociceptor fibers, and A beta low threshold mechanoreceptors.
  • Exploration of central sensitization mechanisms involving dorsal horn processing, neuropeptides, and NMDA receptors.

    • Main Results:

    • Pain is the most disabling symptom, evolving from sympathetic dependence to independence.
    • Alpha 1 adrenoreceptors are implicated as peripheral links in C-nociceptor sensitization.
    • Dynamic mechanoallodynia involves A beta fibers, while static hyperalgesia may involve sensitized C-nociceptors.
    • Central sensitization via excitatory amino acids and NMDA receptors contributes to late-stage pain.

    Conclusions:

    • RSD pain involves intricate peripheral and central nervous system mechanisms.
    • Understanding these pathways is crucial for effective pain management in RSD.
    • The transition to sympathetically independent pain highlights the need for multifaceted treatment strategies.