Welcome to RSDSA’s new website and blog. We’ve updated our presence on the web in order to better serve the CRPS/RSD community. The new website is very user friendly and easy to navigate. The idea is to help you quickly find the information, tools, and strategies you need to understand the diagnosis of and treatments for CRPS — and how to live well despite having this condition.

For those visitors who don’t know about us or about CRPS/RSD, RSDSA is an international not-for-profit organization based in Milford, Conn. Our mission for the last 30+ years is to provide support, education, and hope to all those affected by CRPS/RSD while we drive the search for better treatment options and a cure.

Complex Regional Pain Syndrome (CRPS), formally known as Reflex Sympathetic Dystrophy (RSD), is a difficult-to-diagnose progressive neuroinflammatory disorder characterized by intense, severe pain, swelling, and hypersensitivity to touch. CRPS’ pain is rated as greater than cancer pain or the amputation of a digit on the McGill University pain index.

Those with CRPS/RSD often experience this level of pain 24 hours/seven days a week — so you can understand why it is so debilitating for many. It can be triggered by a minor injury, surgical procedure or other physical trauma and the pain is far out of proportion to the incident. You can learn more about this condition here on the site.

Although it’s categorized as a rare disorder, we believe that there are many undiagnosed people suffering. This site is designed to help:

• People with undiagnosed symptoms
• Individuals newly-diagnosed with CRPS/RSD (You’ll find some very helpful videos on a page just for you.)
• Those living with chronic CRPS/RSD symptoms
• Youth with CRPS/RSD
• Friends and family serving as caregivers
• Medical and research professionals
• Corporations and foundations that support organizations like ours as part of your charitable giving

We’ve built a community for everyone interested in CRPS/RSD – and this website is its home. Please spend some time to explore.

Under the Community tab, you’ll find out how to join us and get involved. You’ll also find out how to connect with others living with CRPS through our peer-to-peer program and to find and join a support group.

Throughout the site and on our YouTube channel you’ll find dozens of videos by leading pain specialists, from individuals with CRPS offering useful advice from their experience, of our many meetings and conferences, about diagnosis and treatment guidelines.

Written by Elliot T. Udell, DPM

In podiatry, when we talk about peripheral neuropathy we generally are referring to conditions that affect the local nerves in the lower extremity. This is distinct from conditions that affect the brain and/or spinal cord Diabetes is one of the leading causes of peripheral neuropathy. Research shows that diabetes affects the tiny nerves and small arteries in the area where the patient is experiencing pain. The pain is generally described as “severe burning” or “pins and needles” and is generally worse at night. Months or years later, this pain may lead to numbness indicating the presence of far greater nerve damage, and in such cases we have to be concerned with the development of ulcerations.

Complex regional pain syndrome (CRPS) presents quite differently. Because my practice is focused on patients with severe foot and ankle pain syndromes, I treat people with both peripheral neuropathy and CRPS. Hence, I am well aware of the overt as well as subtle differences between these conditions.

People with CRPS generally present with a history of an inciting injury, which may be a sprain, fracture or even surgery (many elective surgical procedures can lead to CRPS). They also present with severe pain, which is far more intense than that experienced by people with peripheral neuropathy. The pain is so severe at times that even air blowing on the area can cause a person to wince in distress. People who have CRPS can also present with other symptoms generally not associated with peripheral neuropathy, such as sleep disturbances and clinical depression. The depression results from the physiology and anatomy of the sympathetic nervous system synapses rather than purely from an emotional reaction to the pain. Moreover, we commonly see skin problems associated with CRPS, such as edema and small shiny plaques that are exquisitely painful.

Another significant difference is the tendency of non-treated CRPS to progress to the opposite extremity and to the upper limbs. A glance at the anatomy of the sympathetic nervous system, which runs parallel up and down both sides of the spinal cord with perpendicular crosses from right to left, may explain why this illness can easily progress to other parts of the body. Also, CRPS patients often have both spasms of the muscle and progressive muscle weakness. Untreated, this muscle weakness can lead to atrophy and loss of use of the extremity. Such extensive and debilitating muscle weakness, as well as atrophy, is not common in peripheral neuropathy.

Because the anatomy and physiology of the symptoms are different, so are the treatments of these conditions. The treatment of CRPS is complex; we use intense physical medical modalities and many different types of oral pain medications and antidepressants. Each condition is different, challenging, and time consuming, but the rewards of seeing patients leave their wheel chairs and crutches and return to work and school makes any effort we put into working with these people emotionally rewarding.

Dr. Elliot Udell specializes in pain management of the foot and ankle. He is in practice in Hicksville, New York. He is currently president of the American Society of Podiatric Medicine and is on the board of the American Society of Podiatric Dermatology. He is board certified in Podiatric Primary Care as well as Pain Management. He lectures at medical seminars throughout the US as well as in Europe.