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RSD Signs and Symptoms

The symptoms of RSD/CRPS may progress in three stages acute, dystrophic, and atrophic although this notion is subject to debate.

Acute: burning pain, swelling, increased sensitivity to touch, increased hair and nail growth in the affected region, joint pain, color and temperature changes; first 1-3 months

Dystrophic: constant pain and swelling, limb feels cool and looks bluish, muscle stiffness and atrophy (wasting of the muscles), early osteoporosis (bone loss), 3-6 months

Atrophic: cool and shiny skin, increased muscle stiffness and weakness, symptoms may spread to another limb

Characteristic signs and symptoms of sympathetic nervous system involvement are:

Burning pain
Extreme sensitivity to touch
Skin color changes (red or bluish)
Skin temperature changes (heat or cold)
Pain is usually disproportionate to the degree of injury and can be triggered by using the affected limb or by stress and can be spontaneous or constant.

Symptoms associated with an immune reaction include:

Joint pain
Accumulated immune cells in the site
Frequent infections

Signs of motor system dysfunction include:

Difficulty starting movement
Increased muscle tone
Muscle spasm

Other symptoms include: Migraine headache
Excessive sweating
Dermatitis, eczema

Patients with any chronic illness, including RSD/CRPS, often suffer from depression and anxiety. Skin, muscle, and bone atrophy (wasting) are possible complications of the syndrome. Atrophy may occur because of reduced function of the limb.


RSD/CRPS can be difficult to diagnose and often requires excluding other conditions that produce similar symptoms. A thorough history and neurological examination is of utmost importance. During the exam, the clinician may notice that the response to mild sensory stimuli produces severe pain.

Physical examination involves observing the skin color and temperature, swelling, and vascular reactivity; overgrown and grooved nails; swollen and stiff joints; muscle weakness and atrophy (wasting).

Other conditions are ruled out with appropriate testing that may include MRI studies, a full laboratory panel, EMG/NCV (electrophysiological studies of the nerves and muscles), and a test known as a thermogram, which uses an infrared video camera to measure the emission of heat from the affected limb.

Pregnancy and RSD has its own special set of issues. Click to read about them.