Reflex Sympathetic Dystrophy (RSD) describes a condition, a syndrome, which is also known as Complex Regional Pain Syndrome (CRPS). RSD/CRPS is considered to be perhaps the most painful of all chronic pain disorders. It involves chronic, excruciating, burning pain; pathological changes in bone and skin; excessive sweating; skin discoloration; and extreme sensitivity to touch, among other symptoms.  RSD is divided into two types. One, called RSD/CRPS Type I, happens as a result of soft tissue injury, trauma, a fracture, infection, or... where there is no underlying nerve injury. RSD/CRPS Type II refers to cases resulting from major nerve damage. (Type II had previously been known as "causalgia" and dates back to Civil War days.) RSD/ CRPS affects the nerves, skin, muscles, blood vessels and bones, simultaneously. Parts of the nervous system affected include the motor, sympathetic, DNIC, and the discriminative & affectual pain systems. Symptoms include (but are not limited to):

- Intense "burning" pain, which is felt 24 hours a day, 7 days a week
- Skin color changes (often purple-dark red, sometimes bright red-orange)
- Extreme sensitivity to touch, including that of clothing
- Difficulty tolerating water temperatures
- Nail and hair problems
- Skin becomes shiny and thin
- Difficulty swallowing
- Severe, debilitating headaches
- Body sweats
- Body spasms
- Sensation of painful 'pins and needles'
- Problems with basic motor skills (hands, walking... )
- Sensitivity to sounds

The most common and devastating symptom is excruciating pain which is greatly disproportionate to the injury that caused it. The pain and other symptoms become worse as time goes by, unless it responds to treatment. Symptoms often spread from the originally affected area of the body to other parts of the body. (Brandy has the worst form, known as "Full-Body" or "Intractable" RSD.) There is no cure for RSD/CRPS. There are, however, cases of remission or significant lessening of RSD/CRPS symptons with treatment. Researchers and doctors have come a long way in the understanding and treatment of RSD/CRPS; however, relatively few physicians have the experience or training to diagnose and treat the disorder. Treatments include medications, nerve blocks, implanted medication pumps, implanted nerve simulators, physical therapy, and more. If it is not treated aggressively during the first 3 months, it can be extremely difficult to treat. Everyone responds differently to these treatments; however, people with Intractable RSD (like Brandy) typically don't respond to any of the standard treatments offered in the United States. Everyone with RSD/ CRPS is unique. A treatment that helps one person might not help another. It is a condition which the medical community is continually learning more about. Research is underway in Germany, Australia, South Korea, and Mexico, as well as the United States. The National Institutes of Health has a web page devoted to RSD/CRPS at:

http://www.ninds.nih.gov/disorders/reflex_sympathetic_dystrophy/reflex_sympathetic_dystrophy.htm

“Consider, too, that in publicizing RSD, we generally focus on the pain, not the disabilities that come with it—the legs and hands that no longer work, the bones that become osteoporotic, the joints that become locked, the muscles that become spastic…There is an awful lot we leave out—how a productive member of society can become too disabled to work or take care of her children. We don’t discuss the tremendous personal losses—families, friends, jobs—that RSD wreaks…” So wrote Linda Lang, who has suffered with RSD for nearly 20 years.