Reflex Sympathetic Dystrophy - Condition and Symptoms
Reflex Sympathetic Dystrophy (RSD) is also known as Reflex Sympathetic Dystrophy Syndrome, Complex Regional Pain Syndrome Type I, shoulder-hand syndrome, causalgia, and Sudeck's atrophy.
Reflex Sympathetic Dystrophy is characterized by burning pain and abnormalities in the sensory, motor and autonomic nervous systems. It can appear with no apparent cause in about a third of the people with the condition, but usually appears after a person suffers trauma to a joint or a limb (including injury and surgery). Other conditions that can trigger RSD include heart disease, stroke, degenerative arthritis, nerve entrapment, shingles, breast cancer, barbiturates, and drugs used to treat tuberculosis.
In Reflex Sympathetic Dystrophy, the pain and swelling that are the result of the injury get worse and spread to other parts of the limb, to the limb on the other side of the body, or even to some other unconnected area of the body. The pain gets progressively worse and results in changes to the skin, muscles, joints, and bones.
The condition has three stages:
- In the first stage, the symptoms are burning, flushing, blanching, sweating, swelling, pain, and tenderness. X-rays can show patchy bone thinning.
- In the second stage, a person may have early skin changes of shiny, thickened skin with persistent pain, but diminished swelling and flushing.
- In the third stage, a person experiences loss of motion and function of the area affected, together with scarring and a thinning of the lower layers of the skin. X-rays often show significant signs of osteoporosis.
The actual causes of Reflex Sympathetic Dystrophy are not known, and many people with this syndrome do not respond well to treatment.
In making a diagnosis of RSD, your doctor will conduct a physical exam, ask you if you have injured yourself recently, and gather all the information possible about the injury. He will then note if the continuing pain you are suffering is disproportionate to the injury suffered (if there was one) and will determine whether there is swelling or excessive accumulation of fluid in your tissues (edema) or abnormal sweat gland activity near the site of the pain. A person with RSD often has overgrown and grooved nails, muscle weakness and atrophy, and swollen, stiff joints. A neurological exam is usually called for to look for severe pain as a response to a mild stimulus. Your doctor will also order other tests to rule out conditions that might have the same or similar symptoms.
In areas affected by Reflex Sympathetic Dystrophy, the skin and deep tissues can be red and abnormally warm and are painful to touch. A person with RSD may experience physical changes such as excessive sweating or flushing, swelling of tissues, shiny skin, severe burning pain, changes in hair growth, and changes in the muscles, joints, or bones. Other symptoms include tremor, weakness and muscle twitching.
Because the cause of and cure for Reflex Sympathetic Dystrophy is unknown, treatment centers on controlling pain and maintaining flexibility and mobility of the affected limbs. Treatment generally combines medications, physical therapy, nerve blocks, and psychosocial support.
Filing for Social Security Disability with a Diagnosis of Reflex Sympathetic Dystrophy
Unfortunately, there is no listing for Reflex Sympathetic Dystrophy in Social Security’s guide to disabling conditions (also known as the “Blue Book”), so proving total disability and achieving disability benefits because of a diagnosis of RSD can be difficult because there are no specific criteria for approval. Because the symptoms of RSD often include swollen, painful joints, it may be possible to file for disability benefits under Section 1.02 of the Blue Book Major dysfunction of a joint(s) (due to any cause).
If you choose to file for disability benefits under this section, your medical records should show that RSD has caused you to suffer gross anatomical deformity, such as subluxation, contracture, bony or fibrous ankylosis, instability, as well as chronic joint pain and stiffness with signs of limitation of motion or other abnormal motion of the affected joints. You should submit MRIs, CT scans, or X-rays that show the destruction or abnormality of the affected joints or bones and your medical records should document the fact that at least one weight-bearing joint (hip, knee, or ankle) has been compromised or that at least one major joint in your arms has been adversely affected.
It is also possible that you may choose to file for disability under Section 11.00, Neurological – Adult, perhaps under Section 11.17, Degenerative disease not listed elsewhere, such as Huntington's Chorea, Friedreich's ataxia, and spino-cerebellar degeneration, if your records show that you have disorganized motor function (meaning you are either unable to walk or perform fine motor functions).
Pain is the most debilitating symptom of RSD, so in addition to the actual diagnosis of RSD you should document your pain, whether or not and to what extent it can be alleviated by treatment, what treatments you have pursued and how you have responded to treatment, and how your pain limits your ability to function.
Because RSD is not specifically described in the Blue Book, you should seriously consider obtaining the assistance of a professional with experience handling Social Security Disability cases, such as a Social Security Disability attorney, to assemble your medical documents and present your case.
Your Reflex Sympathetic Dystrophy Disability Case
If you are disabled because of Reflex Sympathetic Dystrophy that is so severe it prevents you from working, you may well be entitled to Social Security Disability benefits. Although total disability based on a diagnosis of Reflex Sympathetic Dystrophy can be difficult to prove compared to other disabling conditions, working closely with medical professionals and a qualified Social Security Disability attorney or advocate to collect and present the appropriate documentation to support your disability claim in front of the Disability Determination Services (DDS) can help to ensure that your Reflex Sympathetic Dystrophy disability case will have the highest possible chance of success.