Topical Prescription Pain Medications for Reflex Sympathetic Dystrophy (RSD) / Complex Regional Pain Syndrome (CRPS)

Reflex sympathetic dystrophy (RSD) is a rare sympathetic nervous system disorder. The sympathetic part of the nervous system controls all the involuntary functions such as the heart beating, blood vessels constricting, and more. The main character of this disease is the excruciating and chronic pain which is a result of abnormal or excessive responses of some parts of the autonomic nervous system. CRPS is an uncommon disease, with a prevalence of <2% in most retrospective series.Prescription pain creams for RSD

While studies have been unable to distinctly pinpoint the real cause behind RSD, it is generally associated with surgery, trauma, nerve injury, radiation therapy, infection, degenerative arthritis, shingles and atherosclerotic cardiovascular disease.

What are the symptoms of RSD?

The main warning sign of RSD or CRPS is a burning sensation in the fingers, arms, shoulders, and/or palms. Some people might suffer from RSD in one leg, and then there are those who suffer in both legs. Both of these conditions are easily misdiagnosed, as they often resemble many other nerve injuries.

With CRPS and RSD, the skin around the affected area may swell and become sensitive to any touching as well as extreme temperatures. The area may sweat profusely as well because the temperature in that specific area is also high compared to the rest of the body. The skin also becomes shiny and there may be discoloration.

Types of Reflex Sympathetic Dystrophy

There are three main stages of RSD:  acute, dystrophic, and atrophic. The severity of each stage varies.

  • Acute RSD – This type lasts for around 3 to 6 months and comes with all basic symptoms of RSD. It can be detected via X-Ray, since it will show any bone changes because of bone thinning.
  • Dystrophic RSD – This type can be prolonged to around 6 months. The skin turns thick with contracture and continuous pain.
  • Atrophic RSD – This one can go on for an amount of time and is quite severe. In this stage, the region may lose its functionality altogether including any movements. The fatty layers of the skin also start to thin.


Treatment of RSD

Like any other disease, the sooner it is treated, the better the results. The treatment of RSD also works best when caught at an early stage. There are many simple and easy ways in which the pain can be relieved and there are medicines to assist. Since the pain can become unbearable, there is a large need to relieve it. One method is placing a cool, damp cloth to the afflicted area. Exercise and stretching can also provide relief.Topical Prescription Pain Medicine

For those in a lot of pain and with painful symptoms, medications would need to be used. Cortisone is one medicine that is commonly used in such a situation, quite often for a long period of time. Other medicines that might be used are clonidine, pregabalin, and amitriptyline.

There is also injection therapy through which the nerves around the infected area are induced with a numbing medication so that it does not reach advanced stages. In addition, there is a surgery in which nerves of the affected area are surgically blocked, while pain meds are infused through intrathecal drug pumps into the spinal cord.

While the pain in RSD can assume huge proportions, it is important to remember that the disorder is physiological in nature. Hence, topical pain medications can come in handy. There are many pain killers that can be used to reduce the pain. There are creams available as well that numb the nerves, which send pain signals to the brain, and hence, the brain never gets the pain signals. This reduces, or at least temporarily relieves, the pain.


Sebastin, S.J. (2011). Complex regional pain syndrome. Indian J Plast Surg, 44(2), 298 – 307. Retrieved from:

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