Reflex Sympathetic Dystrophy is a relatively rare but devastatingly painful disease. It has recently been more appropriately renamed Complex Regional Pain Syndrome. The exact mechanism of this pain syndrome is unknown, but there is thought to be some sort of short circuit between the sympathetic nervous system and the sensory nervous system. When this occurs, people often experience a severe burning discomfort, usually limited to one extremity. It tends to migrate from distal to proximal extremities, meaning it may move from the hand to the shoulder or from the foot to the thigh. Complex Regional Pain Syndrome can be associated with a profound loss of joint range of motion in the affected extremity, as well as hyperasthesia, which is extreme pain even to a light touch with the affected extremity, as well as a fluctuation between hot and cold feelings and color changes involving the affected extremity.
Treatment for Complex Regional Pain Syndrome involves blocking the sympathetic nervous outflow to the affected extremity. When this pain problem involves the arms, the appropriate treatment is to perform a Stellate Ganglion Block. A Stellate Ganglion Block is delivered in the neck just lateral to the trachea. When the affected extremity is a leg, the appropriate treatment is blockage of the sympathetic nervous system at the level of the lumbar spine. This is called a Lumbar Sympathetic Block. These procedures require precise placement of needles and often require the use of fluoroscopic guidance to confirm accurate needle placement. It is not uncommon to require a series of nerve blocks in order to control the level of discomfort a patient experiences.