Stages of RSD

There are two main types of chronic reflexive pain syndrome, also referred to as RSD or reflex sympathetic dystrophy. In Type I disease, the symptoms occur following an illness or injury that causes nerve-related symptoms after an injury that did not directly affect a nerve in the area of symptoms. In type 2 RSD, it is clear that a distinct nerve injury occurred. Even though the two types of RSD have different probable triggers, the symptoms are the same and they go through the same 3 stages as described below:

Stage I: Acute Disease
This stage can last up to three months and is associated with an increased sensitivity to touch and a burning sensation, usually beginning in part of an arm or a leg. It is like having pain from an injury that lasts way too long and is way too severe when comparing it to what would be expected in the injury. It is followed by limb swelling, joint stiffness and the presence of increased redness and warmth in the limb that is affected. The hair and nails may grow faster than normal and excessive sweating is likely.
The arm or leg can alternate between being very cold and very warm. There can be muscle spasms of the affected extremity and blotchy, purple, red, pale, thin and shiny skin might be present.

Stage: Dystrophic Phase
This stage generally lasts from 3 to up to 6 months. Swelling predominates and is constant so that the wrinkles of the skin disappear. The skin is cooler to the tough when compared to the rest of the body. Pain can spread to other areas of the limb and even to the opposite limb. There is worsened stiffness of the affected extremities and the affected areas become even more sensitive to touch.
The nails become cracked instead of growing faster and they break off more readily. The hair growth slows and the muscles become weak. The joints get stiffer over time.

Stage III: Atrophic Phase
This stage usually occurs after six months of having the disease. The affected skin is pale, dry and tightly stretched over the underlying tissue. The skin is also shiny. The joints become contracted and stiff so that getting motion back is nearly impossible. The pain may actually lessen and there might be other areas of the body that become affected. Limbs on the other side of the body might be affected during this stage.
Many of these changes are irreversible with little hope of getting normal function in the limb again. The muscles waste from denervation and from disuse of the muscles. The entire limb may be painful as the disease becomes chronic and permanently debilitating.
It should be noted that not everyone goes through the stages the same and some people can skip a stage. The above is a general outline of how the disease progresses past a year of time.

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