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4 Stages of RSD

Another way doctors look at RSD is through putting the symptoms into four stages. These stages refer to what happens to an RSD patient and at what point. Today, doctors mainly use these stages as a way of diagnosing patients. Using these stages can put people into a box, much in the same way that people who have RSD are put into a box by some doctor's definition of what RSD is. When you read this article, then, take it as one more step to understanding your RSD, not as a complete picture to RSD itself.

Stage One: The Acute Stage

Lasts from one to six months





In this first stage, pain which wasn't there before or was at least was intermittent, now becomes constant. Symptoms of this stage include warmth, sensitivity to touch, stiffness in joints, increased hair or nail growth, and limited mobility. Patients describe a burning pain but the affected limb may actually feel cool to the touch. Some changes in the bones may be apparent on X-Ray(for a complete discussion on the positives and negatives of using X-Rays and other diagnostic tools discussed, see the end of this article).

Stage Two: The Dystrophic Stage

Lasts from two to six months





Pain is still constant, but now any pain that the sufferer is feeling can be increased by any type of rubbing against the skin(such as the wind blowing or a person touching the affected area). Pain from noises and vibrations may begin. There is also discoloration, cooling, and mottling of the affected area. In terms of what happens to the rest of the body, nails can become brittle and ridged. There is also an increase in hair growth. X-Rays may show osteoporosis as well. In this stage, the RSD also starts to affect the mind. The sufferer may start to have short-term memory problems. They may also have an inability to concentrate, and often can't find the right words. Another problem patients may experience is repetitive speech. Thermograms, bone scans, and x-rays are used at this stage to determine if a person has RSD.

Stage Three: The Atrophic Stage

Lasts for an unlimited amount of time

This is the stage that can confuse a lot of patients because the pain can increase or decrease. What needs to be remembered, however, is that the pain is still constant. The limb may become smaller (contract) and there is also a decreased amount of movement in the joints. Pain may also move to other parts of the body. Skin will begin to increase and will often look thin and shiny. The skin may also feel cool to the touch. Irreversible skin damage occurs at this stage and x-rays will show a decrease in minerals in the bones and an increase in osteoporosis. The disease has also progressed in that the pain signals are no longer coming from the original RSD site, rather the brain itself. Because of this, blocks which target only the affected area will no longer work.

Stage Four

Lasts for an unlimited amount of time

In the fourth stage, many forms of treatment will not work, as the RSD has become resistant to it. This is also the stage where internal organs may be affected by the RSD. Thankfully, most people never reach this stage. Treatment at this stage can include using an SCS or TENS unit. It is highly recommended by this site, however, that you discuss all your options with your doctor. Again, most people do not get to this stage.

Problems With Stages

As said in the above introduction to this article, most doctors simply use these stages as a guideline for diagnosing RSD. There are many problems with the stage system, which include:

  • Most of the time patients will have symptoms from multiple stages, making diagnosing which stage a patient is in very hard for a doctor. There is not much to be written about the first two stages. This is because these stages are so short. and, few patients are diagnosed within the first few months.
  • Each patient is different, and may not develop all of the symptoms that are in a select stage.
  • Not all doctors insist on the existence of a fourth stage.
A note on using x-rays, bone-scans, and thermograms to diagnose RSD. While these test may show the existence of RSD, they may also show the existence of different disease entirely, a doctor, therefore, needs to have knowledge of RSD in order to make a correct diagnosis.

In Conclusion

I hope that this article has helped you get a better understanding of what RSD is and what it does to a person. Hopefully, you can use this article to work with your doctor on ways to better treat your RSD. If you want to know some ways that RSD is medically treated, please check our "Medical Treatments" article. Also, after you have read all of this information, you may be worried about how to find a doctor or what questions to ask him/her. By reading our "Dealing With Doctors" article, you may have a better understanding of how to do this. I hope that by reading these articles you will get a better understanding of your RSD, and thus be better able to fight with us in concurring this horrible disease.