The Sympathetic Nervous System & RSD

The sympathetic nervous system supplies all of the body structures — including muscle, tendon, ligament, dura, disk, synovium, bone, and even the internal organs. When one of these sites receives an injury, it’s the sympathetic nervous system’s job to monitor the injury and tell the spinal cord or the brain about it. Sometimes the sympathetic nerves forget to stop monitoring the injury.

This can be compared to a car engine that keeps on running (or dieseling), even after being turned off. When this happens to the sympathetic nerves, a very painful syndrome called Reflex Sympathetic Dystrophy (RSD) can develop. Chronic Regional Pain syndrome (CRPS) is another term that is often used to describe this syndrome.

Symptoms of RSD

There are three classic stages, or symptom complexes, of RSD:

Stage I

1. Cold hyperalgesia – cold hurts. The afflicted body part feels excessive pain to cold.
2. Mechanical hyperalgesia – excessive pain to movement. Movement stimulates pain. Pressure from touch hurts.
3. Vasomotor changes – color changes. Red or blue skin color changes occur.
4. Sudomotor changes – sweating of the affected body part can occur.
5. Scleratomally mediated pain – the pain does not follow the pattern of a particular sensory or motor peripheral nerve or nerve root.
6. Thermogaphic change – infrared medical thermography can map the distribution and presence of skin temperature changes.
7. Sympathetic fiber hyperactivity – the sympathetic nerves are irritable or easily aroused.

Stage II

1. Contracture – loss of range of motion, muscles atrophy (the muscles waste away).
2.  Edema – swelling of the affected body part can occur.

Stage III

1. Sudeks Atrophy – bone loss or thinning can occur.

In addition, there are several other non-classic stages that are now recognized:

1. Visceral somatic convergence – as a result of excess activity coming from the sympathetic nerves supplying the muscles, tendons, ligaments, or other tissues affected, there may be internal organ involvement (cardiac, ophthalmic, dental abnormalities can occur).
2. Motor Form of Dystrophy – movement disorders in the affected body part can occur.
3. Spread – there may be spread of symptoms from the original body part affected to other body parts.

RSD is anything but simple.
Anyone afflicted with sympathetic pain should consult a doctor with specialized training and obtain a medical opinion.

Summary of Sympathetic Function:

Eye: contract pupil

Heart: increase heart rate, contraction and conduction velocity

Arterioles: constriction (narrowing)

Veins: constriction (narrowing)

Lung: bronchial relaxation

Stomach: decrease motility, inhibit secreations, increase sphincter tone

Intestine: decrease motility, inhibit secretions, increase sphincter tone

Gallbladder: contraction of ducts

Urinary Bladder: relaxation of bladder wall, increase sphincter tone

Uterer: increase tone

Uterus: variable

Male Sex Organs: ejaculation

Skin: contraction, slight localized sweat secretion

Spleen Capsule: contraction

Liver: increased glycogen breakdown

Pancreas: decreased secretion, inhibition of insulin and glucagon

Salivary Glands: thick, viscus secretion

Adipose Tissue: lypolysis